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Allergy & Asthma Advocate: Summer 2008Staying Fit with Exercise-Induced Asthma  Summer is a popular time to get outside and exercise. However, for people with asthma, this can be difficult. Asthma is triggered or worsened by a number of factors, but exercise is one of the most common. In fact, an estimated 80% of people with asthma have increased symptoms when they exercise. This is called exercise-induced asthma (EIA). In normal circumstances, airways open with exercise. With EIA, the airways close after about 5-8 minutes of near-maximum physical activity. This can cause symptoms such as coughing, wheezing, shortness of breath and chest tightness. Exercise-induced asthma tends to occur in sports such as track, basketball, tennis and soccer. Symptoms are less likely to happen in sports such as swimming, baseball, football and volleyball. Once exercise stops, most people with EIA recover (even without treatment) after 20-60 minutes. Studies indicate that as many as 15% of athletes suffer from EIA. Studies evaluating elite athletes, such as Olympians, show that up to 40% have symptoms of EIA. There are people who have asthma only associated with exercise, but the majority of people have underlying asthma that worsens with exercise. If you experience symptoms of EIA, you should have an evaluation, including pulmonary-function testing to confirm the diagnosis, develop a plan and rule out the need to look for other causes of symptoms. Allergy skin tests may also be done. The first and best treatment for EIA is making sure that your asthma is well-controlled. The primary medications used for EIA are bronchodilators, such as albuterol or pirbuterol. These should be used at least 15-30 minutes before exercising and may last up to four hours. Cromolyn sodium has also been effective when used pre-exercise and montelukast has been approved in preventing EIA in patients aged 15 years or older. In addition to taking medications, there are other ways to reduce EIA. Avoiding exercise in conditions where air is cold and dry can help, as well as doing warm-up exercises. Appropriate training and conditioning, in addition to breathing through the nose (as opposed to the mouth), may also help reduce EIA. If asthma symptoms are interfering with your ability to exercise, consult an allergist/immunologist to get back on track.
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