Exercise-induced Asthma

What is exercise-induced asthma?

Exercise-induced asthma (EIA) is inflammation and narrowing of the airways. EIA can occur in people with or without asthma. EIA may happen during or after exercise or physical activity, especially in cold weather.

What causes exercise-induced asthma?

The cause of EIA is not known. It is believed that breathing hard, fast, and deeply during exercise causes your airways to become cool and dry. This causes the small muscles in your airway to tighten and narrow your airway. It also causes irritation, which leads to inflammation, and the formation of too much mucus.

What triggers exercise-induced asthma?

Different amounts of exercise can cause EIA in different people. Any of the following may trigger EIA:

• Aerobic exercise: This includes exercise or physical activity where you breathe hard for a long period of time. You may also trigger EIA if you do not warm up before you do aerobic exercise.
  
  
• Exercise in cold and dry air: Your risk of EIA increases during winter sports or activities.
  
  
• Exercise near allergens and chemicals: These can irritate and harm your airways and lungs. Allergens include dust, pollen, and pet dander. Chemicals include chlorine, carbon monoxide, engine smoke, and tobacco smoke.
  
  
• Exercise while you are sick: Exercising with a respiratory illness, such as an infection in your nose, throat, sinuses, or lungs, can trigger EIA.

What are the signs and symptoms of exercise-induced asthma?

Symptoms usually last for 30 to 60 minutes, but can also last for days. You may have one or more of the following:

• Coughing during or after exercise
  
  
• Sore throat
  
  
• Decreased ability to do exercise and physical activity
  
  
• Tightness or pain in your chest
  
  
• Headache
  
  
• Sore and cramping muscles
  
  
• Shortness of breath or wheezing (high-pitched sound when breathing)

How is exercise-induced asthma diagnosed?

Your caregiver will examine you and ask you about other medical conditions, such as allergies, asthma, or lung infections. Tell him about the symptoms you have and what activities cause them. You may need one or more of the following tests:

• Peak flow testing: A peak flow meter is a small, tube-shaped device that measures how much and how fast you exhale.
  
  
• Pulmonary function test: This helps caregivers learn how well your lungs work. During the test, you breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time.
  
  
• Bronchoprovocation testing: This measures how much air you can breathe out as fast as you can. This test is done first to see how well your lungs work normally. Then, your caregiver will give you a chemical to trigger a mild asthma attack. After 10 minutes, your caregiver will repeat the test. If the amount of air you breathe out decreases, it is likely that you have asthma.
  
  
• Eucapnic voluntary hyperventilation challenge (EHVC): You will be asked to breathe in dry air quickly and deeply for 6 minutes. You will then be asked to breathe into a spirometer. A spirometer is a machine that measures how much air you breathe in and out.
  
  
• Exercise testing: You will be asked to walk or run on a treadmill, or ride an exercise bike for a few minutes. You will be asked to breathe into a spirometer before and after the test. Your caregiver will then compare the results.

How is exercise-induced asthma treated?

You may need to avoid things or activities that trigger an EIA attack. You may also need any of the following:

• Inhaled short-acting bronchodilators: These are given to help open your airways quickly. They start to work right away and are used to relieve sudden, severe symptoms, such as trouble breathing. They are called relievers or rescue inhalers.
  
  
• Steroids: These help decrease swelling and open your airways to help you breathe easier. They may be given as pills or in an inhaler. Inhaled steroids are used for long-term control.
  
  
• Antihistamines: These medicines can treat allergies that may be causing your breathing problems.
  
  
• Leukotriene antagonists: These medicines can decrease swelling in your lungs. They may stop you from having more wheezing or shortness of breath. They may also stop your attacks from lasting for long periods.
  
  
• Mast cell stabilizers: These can help prevent swelling in your lungs.

What are the risks of exercise-induced asthma?

Your EIA can get worse if left untreated. You may have trouble doing your usual activities. You may have EIA attacks that occur more often and last longer. You may have increased inflammation in your airway and may not be able to get enough oxygen to your body. This may cause damage to your organs, such as the heart and brain, and become life-threatening.

How can I manage exercise-induced asthma during physical activity?

• Breathe through your nose: This helps warm and moisten outside air before it reaches your airway. Deep breathing can also help open your airway.
  
  
• Cover your mouth and nose when you exercise in the cold: Wear a scarf or mask to help warm the air you breathe in.
  
  
• Warm up and cool down: Warm up by walking or stretching before you exercise. Cool down for at least 10 minutes after heavy exercise. Wait for 2 hours after you eat to exercise.
  
  
• Exercise in clean, warm, humid air: You may have decreased symptoms if you exercise indoors. Do not exercise outdoors during the afternoon or evening when air pollution is highest.
  
  
• Use a peak flow meter: This is a small tube with a measuring scale or meter (like a ruler) on the side. It measures how much and how fast you exhale. A peak flow meter can help tell you when you should treat your EIA.

What can I do to help prevent exercise-induced asthma?

• Rest when you have symptoms or you are sick: Do not exercise if you are already experiencing symptoms of asthma. Do not exercise if you have a lung infection or the flu. After being sick, you may need to rest for 2 to 3 weeks before you exercise again. Ask when you can start exercising again.
  
  
• Eat healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Caffeine can help loosen your tight airway. Eat fish and foods high in beta carotene and lycopene. Eat foods that are low in sodium. Supplements, such as vitamins C and E and fish oils, may also help prevent EIA. Ask your caregiver before you take vitamins or supplements.
  
  
• Prevent colds or the flu: Stay away from people who have colds or the flu. Ask your caregiver if you should get vaccines to help prevent the flu or pneumonia.
  
  
• Do not smoke: If you smoke, it is never too late to quit. Smoking can further harm your lungs. Ask for information if you need help quitting.

Where can I find support and more information?

• American College of Allergy, Asthma, and Immunology
  85 West Algonquin Road, Suite 550
  Arlington Heights , IL 60005
  Phone: 1- 847 - 4271200
  Phone: 1- 800 - 8427777
  Web Address: www.acaai.org
  

• National Asthma Education and Prevention Program
  National Heart, Lung and Blood Institute
  National Asthma Education and Prevention Program
  P.O. Box 30105
  Bethesda , MD 20824-0105
  Phone: 1- 301 - 592-8573
  Web Address: http://www.nhlbi.nih.gov/about/naepp/
  

When should I contact my caregiver?

Contact your caregiver if:

• You cough or wheeze more than usual.
  
  
• Your medicines do not relieve your symptoms as well as they used to.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek immediate help or call 911 if:

• You have wheezing or shortness of breath that does not get better with treatment.
  
  
• You feel weak, dizzy, or faint.
  
  
• You have severe chest pain.
  
  
• Your chest and neck are pulled or sucked in with each breath.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Exercise-induced Asthma