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Exercise Induced Asthma Vs Asthma

How Do Healthcare Providers Diagnose Exercise

What is Exercise-Induced Asthma?

Your provider will ask about your symptoms, including when you have them and how long they last. After listening to your lungs, your provider will ask you to perform an activity that usually triggers your symptoms . Then your provider will measure your lung function with a spirometry test.

During spirometry, you exhale as much air as you can as fast as possible. You breathe into a tube attached to a machine called a spirometer. The machine measures how well your lungs work after exercise.

What Else Can I Do To Prevent Symptoms Or Attacks

Depending on your triggers, you can keep an eye on the levels of allergens in the air and levels of air pollution and ozone , which vary each day.

Choosing to exercise indoors on these high-allergen or high-pollution days could prevent asthma symptoms.

Cold air can provoke asthma symptoms, too. So if you need to be outside when its below freezing, wearing a mask or scarf can help cut down on the temperatures effects on your respiratory system.

Warming up well before competing in sports can also reduce the risk of asthma symptoms developing during competition, in addition to reducing your risk of injury.

Most important: If youre diagnosed with exercise-induced asthma and prescribed an inhaler, that inhaler should be with you at all times so that you have immediate access.

If you have an asthma attack and panic because you dont have your inhaler handy, the stress of the situation can make your breathing even worse.

Whats The Difference Between Asthma And Exercise

The symptoms of both conditions are the same: chest tightness, shortness of breath, wheezing, fatigue or episodes of coughing.

In asthma sufferers, these symptoms have many triggers, such as allergens, weather or temperature changes, and irritants like smoke, fumes and pollution.

When symptoms are triggered by exercise, its called exercise-induced asthma.

You can be diagnosed with exercise-induced asthma without a diagnosis of asthma about 10 percent of the general population experiences asthma symptoms only during exercise, without having underlying asthma.

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Are There Tips To Prevent And Treat Exercise

  • Always use your pre-exercise inhaled drugs.
  • Do warm-up exercises and have a cool-down period after exercise.
  • If the weather is cold, exercise indoors or wear a mask or scarf over your nose and mouth.
  • Avoid exercising outdoors when pollen counts are high , and avoid exercising outdoors when there is high air pollution.
  • Limit exercise when you have a viral infection.
  • Exercise at a level that is appropriate for you.

Again, asthma should not be used as an excuse to avoid exercise. With proper diagnosis and treatment of asthma, you should be able to enjoy the benefits of an exercise program without asthma symptoms.

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How Is Eia Diagnosed

Asthma (Bronchospasm)

A doctor will ask about the family’s asthma and allergy history and about the symptoms and what has triggered them in the past.

After taking a medical history and doing a physical exam, the doctor may ask your child to take a breathing test after exercising. This can be done in the office on a treadmill, after your child runs outside for 6 to 8 minutes, or after doing an activity that’s triggered flare-ups in the past.

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Upmc Experts Can Help

Getting the right tests are the first steps toward an accurate diagnosis. Understanding the differences between the two conditions can help you get treated and back in motion faster.

For more information about EIB and asthma or to schedule an appointment, contact the University of Pittsburgh Asthma Institute at UPMC at 412-648-6161.

For more information about EILO, including diagnostic testing performed by our allergy, pulmonology, and ENT experts, contact the Upper Airway Breathing Center at UPMC at 412-648-6161.

Why Does Exercise Trigger Asthma

During normal breathing, the air we take in is first warmed and moistened by the nasal passages. Because people tend to breathe through their mouths when they exercise, they are inhaling colder and drier air.

In exercise-induced asthma, the muscle bands around the airways are sensitive to these changes in temperature and humidity and react by contracting, which narrows the airway. This results in symptoms of exercise-induced asthma, which include:

  • Unusual fatigue while exercising
  • Shortness of breath when exercising

The symptoms of exercise-induced asthma generally begin within 5 to 20 minutes after the start of exercise, or 5 to 10 minutes after brief exercise has stopped. If you are experiencing any of these symptoms with exercise, inform your doctor.

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Why Exercise Can Be A Trigger

Breathing through the nose warms up the air we breathe in. But when we exercise, particularly exercise that is more strenuous like running, we usually breathe through the mouth instead of the nose. This means were breathing in air thats colder and drier than normal.

If you have asthma, breathing in this cold, dry air causes your airways to tighten and get narrower. This can trigger your asthma symptoms like coughing, wheezing, and breathlessness.

You may come across other triggers when you exercise too, like pollution or pollen if you exercise outside, or dust if you exercise indoors. Chlorine in swimming pools can also trigger symptoms for some people.

Youre more likely to get asthma symptoms when you exercise if:

  • you dont take your preventer inhaler every day as prescribed
  • your airways are already tight and inflamed because of allergies or other triggers like cigarette smoke

Exercise-induced asthma

Rarely, someone not diagnosed with asthma might get asthma-like symptoms from exercising.

This is often called exercise-induced asthma, but a better term is exercise-induced bronchoconstriction because it is not caused by having asthma. However, its important to be assessed for asthma if you have symptoms of EIB.

Bronchoconstriction is when the airways get tighter and narrower as a result of strenuous exercise, particularly if someone is also breathing in cold air.

Find out more about exercise-induced asthma/bronchoconstriction.

Origins Of Pediatric Obese Asthma

Preventing Exercise Induced Asthma

Most pediatric professionals recognize that obesity and asthma symptoms are common conditions in children, with their individual prevalence rates in some countries reaching near 30% . The two conditions have been linked in many high-quality epidemiologic studies. Controversy has surrounded the proposed mechanism of this association, but not surrounded the fact that obesity complicates the diagnosis of childhood asthma and its management. Longitudinal data clearly describe a pattern where obesity pre-dates and increases the risk for incident asthma , though the precise nature of this association remains unknown . It is unlikely that the causal mechanism relating the two conditions is both singular and homogeneous throughout the population, although the mechanism are likely to depend on age, sex and other factors. In young children, rapid early weight gain may be a sign of somatic growth dysregulation that precedes impaired airway development and clinical wheezing . This is consistent with reports of maternal obesity and gestational weight gain preceding an increased incidence of childhood wheeze. Additional investigations involving maternal, pre- and post-natal somatic growth, lung growth and respiratory outcomes are needed to fully describe this early life developmental phenomenon.

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Tips To Manage And Keep Asthma Under Control

You can reduce or prevent exercise-induced asthma symptoms in you or your child by following the advice below:

  • Warm up gently for about 15 minutes before starting intense physical exercise and always cool down after
  • In cold weather, cover your nose and mouth with a scarf or facemask to protect your lungs from the cold air
  • Breathe in through your nose to warm and moisten the cold air before it hits your lungs
  • If you have underlying asthma keep it well-controlled at all times and ensure you have an up to date asthma action plan
  • Avoid triggers that you or your doctor have identified you may need to change your sport or where you exercise
  • Keep a record of how often you use your SABA inhaler and review this with your doctor or asthma nurse regularly
  • If your child has EIB, tell PE teachers and carers about the importance of warm-ups, the signs of EIB and how/when your child should use their inhaler

Some people also recommend taking vitamin C and vitamin E dietary supplements. However theres not enough evidence that these have any beneficial effect on asthma or exercise-induced bronchoconstriction.

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How Is Eia Treated

Doctors sometimes recommend pretreatment for EIA. This means taking medicine before exercising or being very active. The medicine often is the same quick-relief medicine used during flare-ups. Taking it before exercise can help prevent the airway narrowing triggered by exercise.

If pretreatment doesn’t control symptoms, the doctor may recommend using long-term control medicine . This asthma medicine is usually taken regularly over time to reduce airway inflammation.

If your child still has breathing trouble during exercise, let the doctor know. The medicine dosages may need to be adjusted for better control.

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Pearls And Other Issues

It is important to consider the anti-doping regulations present in many athletic programs. Some medications utilized for Exercise-induced bronchoconstriction may require a therapeutic use exemption . ICS, LTRA’s, MCSA’s, inhaled anticholinergics, SABA , antibiotics, 1st generation antihistamines with or without oral decongestant, nasal ipratropium, dextromethorphan, nasal corticosteroids, topical decongestants, and proton pump inhibitors in appropriate doses do not enhance performance and therefore do not require a TUE. Oral steroids and terbutaline are banned and require TUE.

Field Versus Laboratory Testing

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Sport-specific field testing is ideal when resources allow. Studies have had some athletes with negative testing in the laboratory setting but positive results with field testing.19 Variations in temperature, humidity, and other environmental factors can make testing difficult, but these variables may also account for the differences found between the field and the laboratory. Sport-specific tests for activities such as Nordic skiing, ice hockey, speed skating, and figure skating have been shown to accurately reproduce the symptoms of EIB.19,24 If sport-specific field testing is not feasible, then free running at maximal effort can be used to induce symptoms of EIB: It is cost-effective and requires few resources, but caution should be used because it may not trigger EIB in all athletes.19 Difficulty in standardization of the testing environment and cardiovascular monitoring are the main drawbacks to field testing. Potential false-negative results can occur if testing parameters are not achieved.

Laboratory testing allows for easier control of the testing environment and parameters. Ideally, dry air should be used. False-negative results may occur if ambient humid air is used because airway drying is thought to be a trigger in EIB.19 Although it is advantageous to have a controlled environment, relative humidity, pollutants, and other irritants may decrease the likelihood of provoking symptoms of EIB.

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What Types Of Medicines Treat Or Prevent Eib

There are three types of medicines to prevent or treat the symptoms of EIB. Your health care provider can help you find the best treatment program for you based on your asthma history and the type of activity.

  • Short-acting beta agonist / bronchodilator : This medication can prevent symptoms when taken 10 to 15 minutes before exercise. It will help prevent symptoms for up to four hours. This same medication can also treat and reverse the symptoms of EIB should they occur.
  • Long-acting bronchodilator: This needs to be taken 30 to 60 minutes before activity and only once within a 12-hour period. Salmeterol can help prevent EIB symptoms for 10 to 12 hours. This medication is for preventing symptoms. It does not offer any quick relief, so it not for treating symptoms once they begin.
  • Mast cell stabilizers: Cromolyn sodium or nedocromil sodium need to be taken 15 to 20 minutes before exercise. These medications may also help to prevent the late phase reaction of EIB that some people experience. These medications are only for preventing EIB because they do not relieve symptoms once they begin. Some individuals use one of these medicines in combination with a short-acting bronchodilator.

If you have frequent symptoms with usual activity or exercise, talk to your doctor. An increase in your long-term control medications may help. Long-term control medicines, such as inhaled steroids, can help EIB.

Asthma And Daily Life

Initially, asthma might feel challenging to manage, but asthma is a very manageable disease with time and proper treatment. Children with chronic or exercise-induced asthma can lead healthy active lives with proper management and treatment. It is crucial for parents to regularly monitor asthma frequency, triggers, and symptoms. As children get older, the asthma triggers can change or may go away altogether.

The physicians and healthcare providers at Newport Childrens Medical Group are here to help you understand your childs unique healthcare needs and potential asthma triggers. Our staff can develop manageable asthma treatment plans to ensure your childs safety. Schedule an appointment with one of our pediatric pulmonary specialists at the Newport Childrens Medical Group to develop and carry out an asthma treatment plan today.

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What Are The Best Exercises For Someone With Asthma

For people with exercise-induced asthma, some activities are better than others. Activities that involve short, intermittent periods of exertion, such as volleyball, gymnastics, baseball, walking, and wrestling, are generally well tolerated by people with exercise-induced asthma.

Activities that involve long periods of exertion, like soccer, distance running, basketball, and field hockey, may be less well tolerated, as are cold weather sports like ice hockey, cross-country skiing, and ice skating. However, many people with asthma are able to fully participate in these activities.

Swimming, which is a strong endurance sport, is generally better tolerated by those with asthma because it is usually performed in a warm, moist air environment.

Maintaining an active lifestyle, even exercising with asthma, is important for both physical and mental health. You should be able to actively participate in sports and activities.

Managing Your Asthma & Exercising

Exercise-Induced Asthma

Once you and your healthcare provider have established what your exercise regimen should be, keep the following in mind:

  • Follow your prescribed treatment plan and take your controller medication
  • Take your medication before starting to exercise if advised, and always carry your reliever medication.
  • Start your regimen slowly. Take your time before attempting more demanding exercises.
  • Always warm up before exercising, and cool down after.
  • If you develop symptoms while you are exercising, stop and rest. Take your reliever medication.
  • If you usually exercise outdoors and its cold out, op for indoor exercise.
  • If you usually exercise outdoors and the pollution or pollen counts are high, exercise indoors instead. You can check the Air Quality Healthy Index before planning to exercise outdoors.
  • Follow your Asthma Action Plan.

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How Do You Treat Exercise

  • Is struggling to breathe
  • Canââ¬â¢t walk or talk
  • Shows other signs of a severe attack

1. Stop the activity.

  • Have the person sit down and rest.

2. Follow the personââ¬â¢s asthma plan, if possible.

  • Find out if the person has an individualized asthma action plan from a doctor.
  • If so, follow its directions.

3. Give asthma first aid.

4. Resume activity when itââ¬â¢s safe.

  • Wait until the person can breathe easily and is symptom-free before resuming exercise.
  • If symptoms return when person starts exercise again, repeat treatment and stop exercise for rest of day.

5. Follow up.

  • If symptoms do not improve with treatment, call the person’s doctor for advice.

If an attack happens at school:

  • Notify a school nurse or other designated staff member if the child does not have asthma medication or symptoms do not go away within 5 to 10 minutes after using an inhaler.
  • Notify the childââ¬â¢s parents.
  • Do not let the child leave the gym or play area alone.

How Does Exercise Lead To Asthma Symptoms

The symptoms usually start during or after vigorous activity. Rapid, deep breathing causes the airways to narrow. In somebut not allpeople with exercise-induced asthma, exercise triggers an inflammatory reaction.1,4

Symptoms are the worst five to ten minutes after stopping exercise, and they are usually gone 20 to 30 minutes later.4

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What Are Some Treatment Options Available

Just like normal asthma, exercise-induced asthma can worsen breathing, so an emergency plan should be in place. They mostly need to use a regular inhaler, but most allergy doctors prescribe medication like Montelukast. They also suggest using short-acting beta two agonists and long-acting beta two agonists, which they must take 30-60 minutes before exercising. Allergy clinic doctors also offer strategies to reduce their symptoms during exercise. They mostly try to do slow warm-ups, avoid all allergens, and avoid exercising in a cold and dry areas.

Side Effects Of Exercise

Asthma Expiratory Wheeze

Episodes of EIB can cause temporary inflammation and damage to lungs, but its reversible with proper treatment. The biggest complication associated with exercise-induced breathing difficulty is GIVING UP ON EXERCISE!

Some people with EIB feel anxiety, fear, and embarrassment about exercising. Rightfully so! Whats not scary about feeling like you cant breathe?

The truth is avoiding exercise is counterproductive. Its totally possible to have an active life while managing EIB. In fact, exercise improves quality of life.

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When To See Your Doctor

Visit your doctor if you experience symptoms of EIB for the first time.

If youve already been diagnosed with asthma or EIB, see your doctor for regular checkups. This will help your doctor track your progress and adjust your medications as necessary.

Follow up with your doctor if you have EIB and symptoms such as:


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