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Exercise Induced Asthma

Answers to Your Health Questions by David B. Gealt, D.O.

Q. What is Exercise Induced Asthma (EIA)?

A. Otherwise known as exercise induced bronchoconstriction (EIB), it is a transient increase in airway responsiveness after 5-8 minutes of strenuous exercise. One does not need to have underlying asthma to have exercise induced asthma.

Q. What are the common symptoms seen with exercise induced bronchoconstriction?

A. Symptoms can occur as soon as 3 minutes peaking at 10-15 minutes and resolving spontaneously over 30-90 minutes. Symptoms can vary greatly to include wheezing, coughing, chest tightness, shortness of  breath, frequent colds, as well as merely having the feeling of “being out of shape” and seeing ones performance decline. Often the symptoms are worse in colder weather or outdoors.

Q. How is EIB diagnosed?

A. A family history of asthma is the number one risk. Further investigation might be needed in the pediatric population especially if there are some positives in the pre-participation sports physical examination. If one suspects EIB, a diagnosis is easily confirmed by a test called a pulmonary function test in which there is a reduction in lung function comparing baseline readings with post exercise readings.

Q. What is the treatment for exercise induced asthma?

A. Treat any underlying issues such as asthma or an upper respiratory infection first. Treatment involves nonpharmacologic therapy and the use of medications. Educate the athlete on proper warm up techniques and maintaining aerobic conditioning which reduces stimuli for EIB. Avoid triggers such as pollen, cold  temperatures and smoking. Counsel the athlete on appropriate sports. For example cold winter sports such as ice hockey or skiing can exacerbate EIB while swimming or an indoor activity can help reduce underlying stimuli. B2-agonist inhalers can provide complete prevention in 80-90% of patients if taken 10-20 minutes prior to exercise. It is imperative to have a rescue inhaler on the sidelines in case of an attack as well. Coaches and Athletic Trainers should also be aware of any athlete who has exercise induce asthma.

Q. Does exercise induced asthma or EIB prevent an athlete in participating in sports?

A. No, EIB is easily preventable and treatable. As long as controlled, an athlete may participate in any and all sports. If one suspects EIB, further investigation is needed by a properly trained physician.