What Is Exercise Induced Asthma?

Learn More About Diagnosis, Treatment & Prevention

Young jogger using asthma inhaler on the beach
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Exercise induced asthma, or exercise induced bronchoconstriction, causes bronchoconstriction and asthma symptoms such as wheezing, shortness of breath, coughing and chest tightness that develop during exercise. It affects in 7 to 20 percent of the general population.

While you have probably heard of exercise induced asthma before, your asthma care provider probably refers to it as EIB. Asthma doctors prefer the term EIB over exercise induced asthma because exercise is not a risk factor for asthma, but rather a trigger.

Symptoms of Exercise Induced Asthma

Symptoms of exercise induced asthma may occur shortly after a brief period of exercise, or 10 to 15 minutes into a longer period of exercise. The most common symptoms of exercise induced asthma include:

  • Shortness of breath
  • Chest tightness
  • Coughing

Symptoms typically resolve with rest in no more than 30 to 60 minutes. Cold weather increases the frequency and severity of symptoms.

How Exercise Induced Asthma Is Diagnosed

For known asthma patients who experience typical symptoms during or after exercise, a physician will often make a presumptive diagnosis of exercise induced asthma by discussing symptoms with the patient. Many times a doctor will not seek further diagnostic testing unless the patient's exercise induced asthma symptoms persist, or the exercise induced asthma symptoms are not prevented with some of the measures outlined below.

If you do not have an asthma diagnosis, but develop shortness of breath, chest tightness and coughing during or after exercise, further investigation is necessary in order to make sure the symptoms are not due to another condition, such as heart disease.

In many cases a form of exercise testing with pre- and post-exercise spirometry is used to confirm an exercise induced asthma diagnosis. Generally, you will exercise on a treadmill or stationary bicycle until you reach 85 percent of your expected maximum heart rate. You are considered having exercise induced asthma if your FEV1(forced expiratory volume) falls more than 10 percent with exercise.

Some asthma care providers may recommend a bronchoprovocation challenge test, but this is not specific for exercise induced asthma. Similarly, measuring peak flows pre- and post-exercise are not recommended to diagnose exercise induced asthma because results are often inaccurate.

Other causes of the shortness of breath, chest tightness and coughing that mimic exercise induced asthma also need to be considered. This is especially important if you show no other asthma symptoms and do not benefit from some of the preventive measures outlined below. Other diagnoses your doctor may consider include:

How to Prevent Exercise Induced Asthma

If you have poorly controlled asthma and experience symptoms with exercise, treating the poorly controlled asthma may be the most beneficial strategy for you. Exercise induced asthma can generally be prevented using one of the following inhaled medications:

  • Cromolyn sodium (Intal): Cromolyn sodium can be used to prevent exercise induced asthma and may be used in combination with a rapid-acting rescue medication.

For children and adults who exercise intermittently during the day and are not able to take a medication before each activity, a long-acting bronchodilator (LABA) or leukotriene inhibitor may be used:

  • Long-acting bronchodilators: LABAs like Salmeterol and Formoterol, while not recommended as sole treatment for asthma, can be used for exercise induced asthma. Salmeterol and Formoterol should be taken 30 and 5 minutes before exercise, respectively. Neither should be used more frequently than every 12 hours.
  • Leukotriene inhibitors: Leukotriene inhibitors like Montelukast (Singulair) and Zafirlukast (Accolate) can be used to prevent exercise induced asthma symptoms in patients who need longer periods of protection or have problems using inhalers.

If you develop wheezing symptoms or bronchoconstriction after beginning exercise, or you forget to take medication prior to beginning exercise, you will want to use your rescue inhaler and follow your asthma action plan.

Sources:

O'Byrne, Paul. Patient Information. Accessed May 5, 2009. Exercise Induced Asthma

Storms WW. Accessed May 22, 2009. Asthma Associated With Exercise. Immunol Allergy Clin North Am. 2005 Feb;25(1):31-43.

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