Exercise-induced asthma
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Exercise-induced asthma, also known as sports-induced asthma, is a condition in which the airways narrow or constrict during intense physical activity. This can result in various symptoms such as wheezing, coughing, shortness of breath, and others, both during and after exercise. This condition is also known as exercise-induced bronchoconstriction.
Exercise-induced asthma can affect both individuals with and without asthma. When this condition is triggered by exercise, it can make breathing difficult.
People with exercise-induced bronchoconstriction can still participate in physical activity and remain active as long as they manage their symptoms. To prevent an episode of exercise-induced asthma, they can warm up before exercising and use inhalers or other medications to open up their airways.
Symptoms
Symptoms of exercise-induced bronchoconstriction typically appear during or shortly after exercise. If left untreated, these symptoms may last for an hour or longer. These signs include:
- Wheezing
- Coughing
- Difficulty of breathing
- Pain in the chest, discomfort or tightness
- Exhaustion during exercise
- A less impressive athletic effort than anticipated.
- Avoidance of physical activity, which is particularly common in young children.
If you experience exercise-induced bronchoconstriction, it is important to consult your doctor for a diagnosis as soon as possible. This is because some illnesses can produce similar symptoms.
You should seek immediate medical attention if you experience any of the following:
- Difficulty breathing due to rapidly worsening shortness of breath or wheezing.
- If your asthma episodes do not improve even after using a prescription inhaler.
Causes
When exercising, the increased breathing through the mouth can cause the airways to narrow and become constricted, leading to breathing difficulties. This may be exacerbated by cold and dry air, which lacks moisture and can cause dehydration of the air passages. Other irritants such as chemicals, allergens, and air pollution may also contribute to exercise-induced bronchoconstriction. The exact cause of this condition is not fully understood, but increased breathing during exercise may exacerbate symptoms by irritating the airways.
Risk factors
The likelihood of exercise-induced bronchoconstriction is higher in:
- People with asthma. 90% of asthmatics have bronchoconstriction during exercise. However, individuals without asthma are also susceptible to the condition.
- Sport induced asthma. Individuals with asthma may experience symptoms more frequently when engaging in certain sports. These include:
- Endurance sports: Activities that demand continuous physical effort such as long-distance running, soccer, basketball, and other endurance sports may require athletes to breathe heavily and steadily, without much opportunity for rest, potentially triggering asthma symptoms.
- Cold weather sports: Sports that take place in cold weather conditions, like skiing, ice hockey, ice skating, and snowboarding, may also increase the likelihood of asthma symptoms due to the cold air temperatures.
The following are some triggers or risk factors for the condition:
- Dry or cold air
- Air pollution
- Increase pollen in the air
- Swimming pools containing chlorine
- Recovering from respiratory illnesses
- Scents from fresh furniture, paint, or carpet in a gym
- Long-duration breathing exercises like long-distance running, swimming, or soccer
Diagnosis
To diagnose exercise-induced bronchoconstriction, your healthcare provider will conduct a physical examination and take your medical history. Your provider will ask about the timing and duration of your symptoms and may ask you to perform an activity that usually triggers them, such as running. They may also perform lung function tests and other diagnostic procedures to rule out other conditions.
Test of current lung function
A spirometry test is a type of lung function test that measures the airflow and estimates the amount of air in your lungs. It helps healthcare providers evaluate the strength of your lungs and how well you can breathe. After the initial test, providers may have you take a bronchodilator to see if it improves your airflow and compare the results to the first measurement. This test is crucial for ruling out chronic asthma as the underlying cause of your symptoms.
Exercise challenge tests
The exercise challenge test is used to detect exercise-induced bronchoconstriction by increasing breathing rate through intense exercise on stationary equipment or real-life activities such as climbing stairs. Spirometry tests are conducted before and after the exercise to measure changes in lung function, which can provide evidence of exercise-induced bronchoconstriction or exercise-induced asthma problems for people with known asthma.
Methacholine challenge breathing test
The test for exercise-induced bronchoconstriction involves inhaling a substance, typically methacholine, which can narrow the airways in individuals with this condition. The subsequent spirometry test assesses lung function and replicates the conditions that are likely to trigger exercise-induced bronchoconstriction.
Treatment
Asthma triggered by exercise or sports cannot be cured, but it can be managed with proper treatment. Your healthcare provider may prescribe medications that can be taken shortly before exercise or on a daily basis for long-term control. The goal of treatment is to prevent and relieve symptoms, such as wheezing, coughing, and shortness of breath.
Pre-exercise medicines
If your doctor has prescribed a medication to take before to working out, find out how long you need to wait before beginning the exercise.
- Short-acting beta agonists (SABAs) are the most frequently recommended drugs to take before working out. These medications include levalbuterol and albuterol. SABAs are drugs that are breathed to help open airways. Avoid using these medications daily as doing so may reduce their effectiveness.
- Ipratropium (Atrovent HFA) is a drug that can be breathed and may be useful for certain persons in relaxing the airways. Ipratropium is also available in a generic form that can be used with a nebulizer.
Long-term control medicines
When preexercise treatment alone is ineffective, your doctor may recommend a long-term control medication to manage underlying asthma or to control symptoms. Usually, these medications are used every day. They consist of:
- Inhaled corticosteroids, which reduce airway inflammation with this. You inhale these medications to consume them. Before you see the greatest results from this treatment, you may need to utilize it for up to four weeks.
- Combination inhalers, which have a long-acting beta agonist (LABA), a drug that relaxes the airways, along with a corticosteroid. These inhalers are intended for long-term management, however your doctor could advise using one before working out.
- Leukotriene modifiers, leukotriene modifiers are oral medications that can be taken daily or before exercise to reduce inflammation in some people. However, they may cause side effects such as changes in behavior and mood, as well as suicidal thoughts. It’s important to speak with a healthcare provider if experiencing these symptoms.
- Mast cell stabilizers. Symptoms can be avoided by taking this prescription around 15 minutes before activity. This medication is administered by a nebulizer, a device that creates tiny droplets of liquid medicines for inhalation.
