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What Is Exercise Induced Asthma

What Is The Cause That Causes It

What is Exercise-Induced Asthma?

Exercise-induced asthma is due to cooling and relative dryness of the airway due to increased ventilation during exercise.

Cooling and dryness cause changes in the osmolarity of the mucosa, which leads to, on the one hand, there is degranulation of mast cells with the release of mediators; and on the other hand, to produce a direct vagal stimulation.;The result is the appearance of bronchoconstriction.

  • Cold inspired air,
  • The low humidity of the inspired air,
  • Loss of heat from the airway.

Side Effects Of Exercise

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.

What Is Exercised Induced Bronchoconstriction

Exercise-Induced Bronchoconstriction , is a temporary narrowing of the lower airways, occurring after vigorous exercise. It may occur in people with asthma or in people without asthma.

In people with asthma who experience EIB, exercise is an asthma trigger. This means that for some people during vigorous exercise the small airways in the lungs become red, swollen, and may become blocked with mucus. This narrows the airways and makes it more difficult to breathe.

Not everybody that has asthma has EIB and some people with EIB may not have asthma

Read Also: Nsaid Induced Asthma

How To Prevent/overcome Exercise

Although EIB is a common problem for most of the asthmatics, asthma attacks during and after exercises can be well prevented and treated by proper management of your condition.

Taking proper steps to prevent the symptoms naturally is usually recommended for patients. These include:

  • Use asthma inhalers or bronchodilators before exercising
  • Take your medicinesÂ; before exercising
  • Avoid exercising when you are sick
  • Avoid exercising in cold dry air, use a scarf or a mask to cover your nose and mouth if you exercise
  • Warm-up your body for 10-15 minutes before strenuous exercising or physical activities. Do not forget to cool down your body after exercising

Getting the help of best inhaler for exercise induced asthma is one of the sure-shot ways to deal with your problem. You can even carry many of these compact-sized inhalers in your pocket wherever you go.

Besides the above preventive measures, take care that you restrict your exercise on high pollen days. Also, avoid the exercises when the temperature is very low or there is heavy pollution outside.

As these conditions can make your asthma symptoms worse it is best to remain indoors and perform some good indoor exercises like aerobics, dancing, etc.

Remember that, asthma should not be an excuse for you to avoid your daily exercises.

With a bit of care, proper management and plan of action you can treat your condition â to get the benefits of exercising daily without triggering your asthma symptoms.

Is That Chest Tightness And Shortness Of Breath From Exercise Induced Asthma


OR is it angina, in which blood flow to the heart is reduced due to clogged arteries?

The symptoms of angina and exercise induced asthma have some overlap.

Asthma symptoms typically include chest tightness, shortness of breath and wheezing, says Angel Coz, MD, FCCP, board certified pulmonologist, Associate Professor of Medicine, University of Kentucky, Lexington Veterans Affairs Medical Center.

While they can happen at rest, they are more frequent during exercise. The symptoms can resemble those of angina that also tend to be aggravated by exertion.

However, asthma symptoms will typically be relieved by asthma inhalers, whereas angina will not.

Moreover, angina is usually associated with other presenting symptoms like arm discomfort, lightheadedness, nausea or diaphoresis . Angina is relieved by nitroglycerin.

Nitroglycerin for angina episodes comes in the form of a very small pill that the patient places beneath the tongue.

The drugs job is to dilate blood vessels. When the vessels in the heart are dilated, more blood flows through them, providing symptom relief.

  • Angina thats triggered by physical activity or exercise is called stable angina.
  • When it occurs at rest, it is called unstable angina. It can even occur during sleep and awaken the patient.

Also keep in mind that EIA typically presents with a distinctive wheezing sound, and this is absent during a bout of angina.

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What Types Of Sports Are Best For People With Eib

Activities most likely to trigger EIB:

  • Sports or activities in cold/dry weather
  • Sports or activities that need constant activity

Activities least likely to trigger EIB:

  • Sports or activities that use short bursts of exercise
  • Walking or leisure biking
  • Swimming in a warm, humid environment

It is important to consult with your health care provider before beginning any exercise program. Pace yourself. With effective management, people with EIB can perform and excel in a variety of sports. Many Olympic athletes and professional athletes with EIB excel in their sports.

Are There Home Remedies For Exercise

Work with your health-care professional to develop an action plan. Follow your treatment plan closely to avoid an asthma attack during and after exercising. If you do have an asthma attack, the action plan will help you control the attack and make the decision about when to seek medical care.

If you should have an asthma attack, move to the next step of your action plan. Keep the following tips in mind:

  • Take only the medications your health-care professional has prescribed for your asthma. Take them as directed.
  • If the medication is not working, do not take more than you have been directed to take. Overusing asthma medications can be dangerous.
  • Do not take cough medicine. These medicines do not help asthma and may cause unwanted side effects.
  • Aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen , can cause asthma to worsen in certain individuals. These medications should not be taken without the advice of your health-care professional.
  • Do not use nonprescription inhalers. These contain a very short-acting inhaler that may not last long enough to relieve an asthma attack and may cause unwanted side effects.
  • Do not take any nonprescription preparations, herbs, or supplements even if they are completely “natural,” without talking to your health-care professional first. Some of these may have unwanted side effects or interfere with your medications.
  • Be prepared to go on to the next step of your action plan if necessary.

Read Also: How To Help A Child Having An Asthma Attack

Exercise Induced Asthma Symptoms

Up to 85% of asthmatics have symptoms of wheezing during or following exercise. In addition, many non-asthmatic patients with allergies or a family history of allergy experience bronchospasm or constricted airways caused by exercise. Other symptoms include an accelerated heart rate, coughing and chest tightness occurring five to ten minutes after exercise.

Exposure to cold air and low humidity tends to worsen symptoms since both are thought to increase heat loss from the airways. Nasal blockage worsens exercise related asthma because the inspired air is not humidified and warmed in the nose. Air pollutants , high pollen counts, and viral respiratory tract infections also increase the severity of wheezing following exercise.

Exercise Induced Asthma That Cause Wheezing:1. Free running 2. Treadmill running4. Swimming

Testing:1. A patient history is taken2. A breathing test is done while the patient is at rest to determine if the patient has undiagnosed asthma.;This test may be repeated after exercise.3. Specialized tests may be performed, which can include cycling, running or using the treadmill to diagnose asthma.

Treatment:1. Careful selection of exercise activities such as walking, light jogging, leisure biking, and hiking may aid those who cannot tolerate strenuous outdoor running sports.

3. Athletes should restrict exercising when they have viral infections, when pollen and air pollution levels are high, or when temperatures are extremely low.

How Does Exercise Trigger Asthma Symptoms

What is Exercise Induced Asthma?

Doctors think they know why some people’s asthma is made worse by exercise .Normally, people breathe through their nose. Your nose acts as an air filter. It controls the temperature and humidity of the air before it reaches your lungs.When you exercise, your body wants more air. ;Your breathing speeds up to get more air. You start breathing through your mouth, so you can gulp down more air. But air that comes through your mouth has not been filtered, warmed, or humidified by your nose. This means the air that gets to your airways is cooler and drier than usual.If you have asthma, your extra-sensitive airways don’t like cool dry air. Your airways react: the muscles around the airways twitch and squeeze tighter. Tighter airways mean there is less space for the air to pass through. This makes you wheeze, cough, and feel short of breath.

Also Check: Can Someone With Asthma Take Cough Medicine

Can I Prevent Exercise

With planning and preparation, you may be able to avoid an asthma episode. Before physical activity, you should:

  • Allow yourself time to warm up: Before starting any physical activity or exercise, warm up for six to 10 minutes. Warmup routines vary depending on your age, health and sport or activity. Talk to your provider about the right one for you.
  • Check pollen and air quality: Before going outside to exercise, check the air quality index. If pollution and pollen levels are high, you may want to stay indoors.
  • Cover your mouth and nose: Use a mask, scarf or gaiter to protect your airways from cold, dry air.
  • Manage asthma symptoms: If you have asthma, work with your provider to get symptoms under control before you start an exercise program. Follow your providers instructions when using inhalers and taking asthma medications.
  • Tell coaches and teachers: If your child has asthma, make sure teachers and coaches are aware. Adults should know what symptoms to watch for, what to do if symptoms appear and how to help with medications.
  • Watch for symptoms: Monitor yourself for symptoms of sports-induced asthma. Have a plan in place if you notice signs of an EIB episode. Remember that symptoms can appear minutes after you finish exercising.

You Swim In A Chlorinated Pool

Generally, swimming is a great sport for people with exercise-induced asthma, because it still requires cardio demand, but the humid environment makes bronchoconstriction less likely. However, too much exposure to chlorine can irritate your respiratory tract. In fact, a study published in the journal;Environmental Health found that early life exposure to swimming pools that contain chlorine was linked to early-onset asthma in children.

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Can You Die From Exercise

Asthma is dangerous. In the wrong situation, exercise-induced asthma can be life-threatening.;

Talk to your doctor if you develop chest tightness or difficulty breathing anytime, but especially during exercise. You can take medications to keep exercise-induced asthma from happening and to stop the symptoms once they start.

Enhancing Healthcare Team Outcomes

Is Asthma Stopping You From Exercising?

Care coordination between primary care providers, pulmonologists, ENT, sports medicine practitioners, and coaches is required to ensure proper diagnosis and treatment of Exercise-induced bronchoconstriction. Sports coaches play an important role in identifying athletes who are experiencing symptoms during the practice or who express a desire to quit the sport due to poor fitness, as it can be a sign of EIB. The education of coaches is important to ensure adherence to face protection from cold, dry air, exposure to pollutants, particulate matter, and allergens during practice. Coaches can also work with school administration to ensure practice locations and pool chemicals are safe for practice. Primary care sports medicine practitioners may be the first contact for athletes with symptoms. Proper testing for diagnosis is required as clinical symptoms are not sensitive or specific, and some patients are asymptomatic. Differential diagnosis includes the entire airway, and each part may contribute to symptoms requiring referral to an otolaryngologist. Coordination with pulmonology for testing may be required. Pulmonology may already be involved in asthma management in hard to control patients. Communication and coordination will lead to an optimal diagnosis, treatment, treatment adherence, and control of bronchoconstriction, allowing patients to participate in an activity as they desire.

Read Also: Is Drinking Water Good For Asthma

Physiologic Limitation And Deconditioning

Increased ventilation is a normal physiologic response to exercise. However, the increase in respiratory drive and work may be interpreted as pathologic by subjects who find that it limits their ability to perform to their expectations or results in “normal” discomfort. In a study by Abu-hasan et al, physiologic limitation was the most common reason for exercise-induced dyspnea in pediatric patients who underwent cardiopulmonary exercise testing . It occurred in 52% of referrals for EIB; of those, two thirds had normal or above normal cardiovascular conditioning. The dyspnea is likely related to the increase in ventilation that accompanies high intensity exercise which is necessary to meet increased metabolic demands. Minute ventilation and respiratory drive are further increased at or above the lactate or ventilatory threshold, the point in incremental exercise when lactate begins to accumulate in the serum; excess lactate buildup results in exercise-associated increases in ventilation and ultimately hypocapnia. Subjects perceive dyspnea and shortness of breath at these high exercise intensities as abnormal.

Exercise rehabilitation or training can improve aerobic fitness and endurance and can shift the lactate/ventilatory threshold so more work is required before lactate accumulates and ventilation increases. Improved aerobic fitness through exercise training can thus decrease the hyperpnea and dyspnea associated with exercise .

Managing Your Asthma & Exercising

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.

Also Check: What Causes A Wheeze In Asthma

Diagnosing And Treating Eib

Your doctor may ask about;your history and do a physical exam. Suspected EIB will be confirmed with objective testing.;Since most people with EIB do not have symptoms without exercise, you may be asked to exercise and then have your breathing tested.

You may need treatment before and/or during exercise. The first type of drug used is usually a short-acting inhaler such as albuterol. These types of inhaler medications are sometimes referred to as “rescue medications.” They are taken about 15 minutes before exercise starts and repeated during or after exercise, if needed.

If you have more severe asthma or if rescue medications are not working, you may need to take a “controller medication.” This type of asthma medication is taken regularly to help keep your lungs open. Examples of controller medications include inhaled steroids and medications taken by mouth to prevent bronchospasm.

What Other Conditions Feel Like Exercise

What Causes Exercise Induced Asthma?

Other conditions have symptoms similar to exercise-induced asthma. Some of these arent serious, while others need medical attention.

  • Being out of shape. If you havent exercised in a while, then getting a little bit of exercise can make you feel out of breath quite easily. This is different from exercise-induced asthma, however. If your symptoms go away quickly when you stop exercising, theyre more likely due to being out of shape than exercise-induced asthma. If youre just getting back into exercise, start slowly. Take time to warm up, and listen to your body. If you arent sure, talk to your doctor.
  • Chest pain /heart troubles. Chest pain can be a symptom of asthma. But it can also be a sign that you are having trouble with your heart. If you have chest pain when you exercise , talk to your doctor right away.
  • Exercise-induced laryngospasm. Sometimes, exercise can cause a temporary spasm of your vocal cords. This can feel like exercise-induced asthma, because you might experience difficulty breathing, coughing, and chest pain. But exercise-induced laryngospasm starts fast and goes away quickly when you stop exercising. It only affects air flowing into your lungs, not out of your lungs, often causing a strange noise to your in-breath. Asthma medicines like albuterol wont help with laryngospasm. This condition is usually diagnosed based on symptoms. But sometimes a provider may use a camera test to look at your vocal cords while you exercise.

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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.

You Struggle To Run Long Distances

Do you enjoy going for 10-mile runs? That will change if you develop exercise-induced asthma. The deep breathing that running requires, plus the sheer distance, can decrease your endurance if your airways are constricted. Youre not going to be able to run as long or as far, Dr. Ogden says. Your symptoms will kick in before the runnings over and youll find yourself struggling. In that situation, meds or an inhaler can help you power through runs from a 5K to a marathon Here are some training tips for beginners who want to run a marathon. Regardless of your symptom or your environment, seeing an asthma and allergy specialist for an evaluation will set you on the road to relief.

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