Exercise Induced Asthma

SAAD SANYURAH, M.D.

Allergy and Asthma Treatment Center

Exercise-Induced Asthma

Many individuals are troubled by shortness of breath, cough, and wheezing when they try to exert themselves.  Some people think these are normal signs of fatigue and of being out of shape and they restructure their lifestyle to avoid all types of physical exertion.

Exercise induced asthma (EIA) may develop in any person with asthma or other respiratory allergies.  It can also occur in normal people who had upper respiratory infections or been exposed to air pollutants, particularly sulfur dioxide.  Forty percent of non-asthmatic people with hay fever or nasal allergies experience EIA.  This group includes many world-class athletes.

EIA is most common in older children and adolescents, although it can occur in toddlers and adults of any age.  Free running in cold dry air causes the most severe asthma, but EIA can be triggered by any form of exercise.

Swimming is least capable of producing symptoms.  Symptoms of exercise induced asthma begin five to ten minutes after the beginning of exercise.  These symptoms include chest tightness, shortness of breath, wheezing, cough and occasionally stomach ache and headache.  Very often a cough may be the only symptom the person recognizes. Sometimes the symptoms begin about fifteen minutes and occasionally up to six hours after the exercise is completed.

Many patients, parents, teachers, and coaches believe that anybody with EIA should be kept on the sidelines and not participate in any exercise activity.  This is wrong.  With proper management and education, most persons who have asthma should be able to participate fully in physical activities on an ongoing basis.

Several measures can be suggested to prevent or reduce the severity of exercise induced asthma.  These include:

Breathing through the nose while exercising may reduce the degree of EIA.  This helps to warm it up and filter the inhaled air.  However it may be difficult to get enough air through the nose alone during vigorous exercise.

Light running, stretching, or any form of warm-up that are performed before beginning strenuous activity have been shown to prevent or reduce EIA.

Some inhaled medications, are very effective in preventing EIA.  These should be used before engaging in exercise activity.

Alternative forms of exercise including swimming and indoor jogging may be helpful for individuals who experience symptoms so severe that they can not participate in outdoor sports during winter.. Also, in cold and dry climate conditions, breathing through a scarf or mask may be helpful.

Avoid exercising during episodes of common cold or viral infections.

Warm down!  It is helpful to gradually reduce the exercise activity rather than suddenly stop it.  This is known as warming down.

Treatment of nasal and upper airway allergies can be helpful in those individuals who suffer from them and experience EIA.

Finally I would like to close this article with this fact. A signicant number of Olympic athletes have exercise induced asthma.