Exercise-Induced Asthma – Diagnosis and Treatment
Diagnosis
Checking Lung Performance at Rest
Doctors often begin by checking how well a person’s lungs are working when they are not exercising. This test helps show if there are breathing problems even before activity starts.
It helps to find out if long-term asthma could be causing symptoms.
Doctors sometimes repeat the test after the person uses a medicine that helps open the airways, called a bronchodilator. Improvement in breathing after this medicine can give useful information about how the lungs react.
Measuring Breathing with a Lung Monitor
Many clinics use a spirometer as a simple tool to check lung function. The spirometer calculates the amount of air a person can breathe out and how fast they blow the air out after taking a deep breath.
This machine provides important numbers like forced expiratory volume (FEV1), which shows how much air leaves the lungs in one second.
A table showing spirometry readings might look like this:
| Test Name | What It Measures | Why It’s Important |
|---|---|---|
| FEV1 | Air exhaled in 1 second | Finds airway narrowing |
| FVC | Total exhaled air | Looks at lung capacity |
Testing Response After Exercise
To see if exercise itself causes problems, doctors may supervise a workout. The person could run on a treadmill or ride a stationary bike to raise their heart and breathing rates.
The activity needs to be hard enough to possibly bring on symptoms.
After the exercise, doctors check lung function with another breathing test. A reversible drop in numbers often means exercise-induced asthma or bronchoconstriction.
- Uses spirometry before and after activity.
- Simulates real-world exercise challenges.
- Results show if the airways narrow with exercise.
Breathing Test With a Special Trigger
Doctors may use a methacholine breathing test, which involves inhaling a substance that can cause airways to get smaller in those who have sensitive lungs. After breathing in methacholine, doctors perform spirometry to see if lung function is reduced.
This test mimics the kind of airway tightening a person might face during exercise. It helps confirm if bronchoconstriction is present, even if regular exercise testing did not trigger symptoms.
Treatment
Medicines to Use Before Physical Activity
Many people with exercise-triggered asthma use medicines before they start being active. These medicines are usually quick-acting inhalers called short-acting beta agonists (SABAs).
They help widen the airways, making it easier to breathe during exercise. Some people may use an inhaled bronchodilator that relaxes the muscles around the airways.
For those who want to use a nebulizer, a non-prescription version of this type of medication may be available. People should avoid using these quick-relief treatments too often, as overuse can make them less effective.
| Medicine Type | How It Helps |
|---|---|
| Short-acting beta agonists | Opens up airways quickly |
| Anticholinergic | Relaxes airway muscles |
Tip: Always ask your healthcare provider how soon before activity you should take these medicines.
Daily Medicines for Ongoing Asthma Control
When symptoms are not controlled with just before-exercise treatment, doctors may recommend daily medicines to manage asthma regularly.
These long-term control drugs may include inhaled corticosteroids to reduce swelling and irritation in the airways. It can take several weeks before people notice their full effect.
Some inhalers combine a steroid with a long-acting beta agonist (LABA). These are used for maintenance and sometimes may be used before exercise if the provider suggests it.
There are also leukotriene receptor antagonists. These are pills that help some people by blocking certain inflammatory signals. They can be taken every day or before exercise, if started at least two hours before activity.
Side effects might include mood changes or unusual behaviors, so it’s important to talk with a provider if you notice these problems.
Using Quick-Acting Inhalers Wisely
Relying only on fast-acting inhalers for asthma can be risky. If someone finds they need their quick-relief inhaler every day, or uses it many times each week, this can be a sign that their treatment plan needs to be changed.
Tracking how often inhalers are used can help doctors spot problems early.
Keep a Record:
- Number of puffs per week.
- How often an inhaler is used before exercise.
- Extra uses for sudden symptoms.
If frequent use occurs, doctors may need to adjust the long-term control medicine.
Self-Care
Supporting Children in the School Environment
At school, students with exercise-induced bronchoconstriction need support plans in place. Parents and caregivers should work with a healthcare provider to make an action plan. This plan should be shared with teachers, coaches, and school nurses.
The action plan needs to clearly list the child’s asthma treatments, when these should be used, and signs that symptoms might be starting.
Staff should know how to recognize early symptoms like coughing, wheezing, or shortness of breath. If symptoms begin, staff should follow the steps in the action plan right away.
A sample action plan table might look like this:
| Symptom | What To Do | Who To Notify |
|---|---|---|
| Mild cough | Use reliever inhaler | Coach or teacher |
| Severe wheezing | Call the school nurse; follow instructions | Nurse, parents |
Open communication between parents, school staff, and healthcare providers helps students stay safe while exercising at school.
Other Treatment Approaches
Some people try different options like fish oil or vitamin C to help with exercise-induced bronchoconstriction.
While some suggest these supplements, there is not enough strong evidence to prove they work. Most alternative treatments have not shown clear benefits for managing these symptoms.
Getting Ready for Your Visit
Before seeing a provider, gather some key information. The provider may ask about your symptoms, such as when they start (before, during, or after exercise), how long they last, and if they occur outside of physical activity.
Write down any recent changes in workouts or routines.
List all regular activities, any diagnosed allergies or asthma, and any other existing health conditions. Bring a list of current medications, including the dose of each, as well as any supplements or herbal products.
Questions to consider:
- Do symptoms always occur with exercise or only in certain places?
- Are there any breathing problems when not being active?
- Have you made any recent changes to your exercise plan?
