Allercy and Asthma Health
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The Official Publication of AAN - MA

What is Exercise-Induced Bronchoconstriction?

Biking

By Sarah M. Varekojis, PhD, RRT, FAARC

This time of year often finds people either working hard to maintain their New Year’s resolutions or eagerly anticipating warmer temperatures. For many, both of these pursuits involve physical activity of some form or another, from biking and swimming to walking, team sports, and more. For some, this also means managing exercise-induced bronchoconstriction (EIB).

EIB is a narrowing of the lower airways in the lungs in response to physical activity. The condition used to be called “exercise-induced asthma,” but that title is no longer considered valid because exercise is not actually a cause of asthma. But it does lead to asthma-like symptoms that result from the narrowing of the lower airways.

Cool, dry air to blame

It is believed that the rapid inhalation of cool, dry air is a major trigger for the asthma symptoms people experience with EIB. Those symptoms are the same as others with asthma experience, including wheezing, tightness in the chest, coughing, and shortness of breath.

These symptoms usually begin between five and 20 minutes after starting physical activity and can continue for 15 minutes or longer after finishing exercise. EIB affects both kids and adults, and can affect both those with other asthma triggers and those without.

The good news is, people who are affected by EIB do not have to sit on the sidelines because of their symptoms. They are encouraged to work with their health care provider to find ways to prevent and treat their EIB so they can participate fully in physical activities.

Medications can help

EIB can be managed with medications prescribed by your health care provider. For those with other asthma triggers, the long-term asthma control medications you are already taking can also help prevent EIB.

If you are not already taking long-term asthma control medications, your health care provider may recommend use of these medications to prevent EIB. Also, short-acting asthma rescue medications can be used both 15-20 minutes before activity to help prevent the development of EIB and as needed during activity to relieve wheezing, chest tightness, and cough.

It is best to talk to your health care provider about the medication plan that will work best for you.

Choose activities with EIB in mind

There are also certain types of physical activity that are less likely to cause EIB symptoms. Sports like volleyball, gymnastics, baseball, wrestling, golf, football, and swimming usually require shorter periods of activity and may be better than sports like long distance running, soccer, and basketball that require more constant activity levels.

Activities such as walking, hiking, and recreational biking may also be good choices for the same reason.

Sports like ice hockey, ice skating, and snow skiing may be challenging because they all take place in a cold environment, which can make the EIB trigger worse.

You and your family may be able to modify your activities or try different activities that may lessen your symptoms — it may take a little compromise and experimentation to find the kind of physical activity that works best for you.

Stay in the game

Talk to your health care provider if you think you have EIB. You can be tested and you and your health care provider can work together to develop a plan to keep you in the game!

Sarah Varekojis is a member of the American Association for Respiratory Care from Ohio, where she currently serves as an associate professor and director of clinical education in the respiratory therapy program at Ohio State University in Columbus.

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