Do you cough, wheeze, and have a tight chest or shortness of breath when you exercise?
If yes, you may have exercise-induced bronchoconstriction (EIB). This happens when the tubes that bring air into and out of your lungs narrow with exercise, causing symptoms of asthma.
An estimated 300 million people worldwide have asthma, according to the World Health Organization, and strenuous exercise can make it worse. Some people with EIB do not otherwise have asthma, and people with allergies may also have trouble breathing dur-ing exercise.
Symptoms If you have EIB, you may have problems breathing within 5 to 20 minutes after exercise. Your symptoms may include wheezing, tight chest, cough, shortness of breath, and, rarely, chest pain.
Triggers People with EIB are typically very sensitive to both low temperatures and dry air. Air is usually warmed and humidified by the nose, but during demanding activity, people breathe more through their mouths. This allows cold, dry air to reach your lower airways and your lungs without passing through your nose, triggering asthma symptoms. Air pollutants, high pollen levels, and viral respiratory infections may also be triggers. Other causes of symptoms while exercising include being out of shape, poorly controlled nasal allergies, and vocal cord issues.
Hiking, walking, and leisure biking are good sporting activities for people with EIB.
Diagnosis Wheezing or tightness in your chest can be serious, so let your physician know about your symptoms. Your physician can help you by getting your health history, performing a breathing test called spirometry at rest, and doing a follow-up exercise challenge test. If your breathing test shows that you might have asthma, your physician may give you a medication, such as albuterol, to inhale. If your breathing test numbers improve after inhaling the medicine, then the diagnosis of asthma is more likely.
You may be asked to take an additional test, called a bronchoprovocation challenge test. Your physician will have you exercise in the sport you play, run outside, or cycle or run on a treadmill. Before and after the exercise, your physician will test the amount of air you force out of your lungs with a spirometry test. If you exhale air less forcefully after exercise, the problem may be EIB.
Treatment If you have been diagnosed with EIB, talk with your doctor before you begin an exercise program. Together, you can develop a treatment plan that will allow you to participate in activities with minimal asthma symptoms.
EIB associated with more generalized asthma is prevented with controller medications taken regularly (such as mast cell stabilizers, inhaled steroids, and leukotriene modifiers) or by using medicines before you exercise (short-acting beta-agonists, such as albuterol). When EIB symptoms occur, they can be treated with short-acting beta-agonists. In addition to taking medications, warming up and cooling down as part of your exercise routine may prevent or lessen EIB. You may want to limit exercise when you have a viral infection, air temperatures are low, or pollen and
air pollution levels are high.
Exercising with EIB People with EIB are still able to exercise – and should exercise regularly. But you need to be sure that you are doing the right kind and right amount of exercise.
The sport you choose can affect your symptoms. Swimming is considered less likely to cause asthma symptoms because the warm, humid environment of the pool does not aggravate the airways. Hiking, walking, and leisure biking are also good sporting activities for people with EIB. Team sports that require short bursts of energy, such as baseball, football, and short-term track and field, are less likely to cause symptoms than are sports that have a lot of ongoing activity, such as soccer, basketball, field hockey, or long-distance running. Cold weather activities like cross-country skiing and ice hockey are more likely to make symptoms worse, but with proper diagnosis and treatment, many people with EIB can participate and excel in almost any sport or activity.
Exercise is important and provides many health benefits, especially for people with asthma. So don’t give up on having an active lifestyle.
Source: American Academy of Allergy, Asthma & Immunology, aaaai.org
This article was originally published in Coping® with Allergies & Asthma magazine, Spring/Summer 2016.