Exercise may be a significant trigger of asthma in many individuals. More than one-third of athletes exercising in very cold conditions, such as cross-country skiing, may show evidence of asthma. These individuals experience breathing difficulty, wheezing, and chest tightness several minutes into exercise. Many are able to exercise through the acute wheezing and after 20 to 30 minutes experience a refractory period, during which time breathing is less obstructed. Detailed exercise spirometric testing can be used to diagnose asthma or to suggest other causes, such as breathing difficulties induced by reconditioning or exercise aversion.
There are a variety of options for the prevention and treatment of exercise-induced asthma (EIA). Choice of sport affects the likelihood of experiencing symptoms. Swimming is usually well tolerated, while outdoor winter sports trigger more symptoms. In addition, your doctor may suggest several medications to prevent or treat the symptoms associated with EIA. The beta-agonist albuterol is a frequent first choice of medication and is used throughout the world. Albuterol has the advantage of being accepted by most sports organizations (including the International Olympic Committee), though sometimes its use must be declared in advance of competition by the treating physician. It should be taken 15 to 20 minutes prior to exertion, but it may be used during an event if symptoms are noted. Its effects may last for several hours. Salmeterol, another beta-agonist, has a slower onset of action but may provide protection up to nine or more hours. Cromolyn or nedocromil taken by inhalation prior to exercise is also effective prevention for many people.
Sometimes exercise is simply one of many triggers for a person with chronic persistent asthma, and treatment must be directed at controlling the inflammation of asthma. These individuals should be treated with daily anti-inflammatory medication, according to the guidelines of the National Asthma Education and Prevention Program. Doctors will look for other evidence of more persistent asthma in athletes with exercise-induced wheezing, because the symptoms can be subtle. Chronic nocturnal cough, nonspecific chest tightness, and postviral persistent bronchitis may be clues that airway reactivity is present between periods of exercise. In addition to the treatments noted above, inhaled corticosteroids, leukotriene modifiers, and theophylline are options.
Source:Bruce Ryhal, M.D., Allergies and Asthma in Sports
There are a variety of options for the prevention and treatment of exercise-induced asthma (EIA). Choice of sport affects the likelihood of experiencing symptoms. Swimming is usually well tolerated, while outdoor winter sports trigger more symptoms. In addition, your doctor may suggest several medications to prevent or treat the symptoms associated with EIA. The beta-agonist albuterol is a frequent first choice of medication and is used throughout the world. Albuterol has the advantage of being accepted by most sports organizations (including the International Olympic Committee), though sometimes its use must be declared in advance of competition by the treating physician. It should be taken 15 to 20 minutes prior to exertion, but it may be used during an event if symptoms are noted. Its effects may last for several hours. Salmeterol, another beta-agonist, has a slower onset of action but may provide protection up to nine or more hours. Cromolyn or nedocromil taken by inhalation prior to exercise is also effective prevention for many people.
Sometimes exercise is simply one of many triggers for a person with chronic persistent asthma, and treatment must be directed at controlling the inflammation of asthma. These individuals should be treated with daily anti-inflammatory medication, according to the guidelines of the National Asthma Education and Prevention Program. Doctors will look for other evidence of more persistent asthma in athletes with exercise-induced wheezing, because the symptoms can be subtle. Chronic nocturnal cough, nonspecific chest tightness, and postviral persistent bronchitis may be clues that airway reactivity is present between periods of exercise. In addition to the treatments noted above, inhaled corticosteroids, leukotriene modifiers, and theophylline are options.
Source:Bruce Ryhal, M.D., Allergies and Asthma in Sports
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