Exercise-induced asthma (EIA), also known as exercise-induced bronchoconstriction (EIB), causes airways to narrow during or shortly after physical activity, making breathing difficult. This article explores whether EIA can improve or resolve and discusses management strategies.
Understanding Exercise-Induced Asthma
Individuals with EIA experience symptoms like coughing, wheezing, shortness of breath, chest tightness, or unusual fatigue during physical activity. These symptoms typically appear 5 to 20 minutes into or shortly after exercise, lasting an hour or more if untreated.
Triggers for EIA include cold, dry air, which dehydrates and irritates airways. Other triggers are air pollution, high pollen counts, and irritants like chlorine fumes. Continuous, intense aerobic activities, such as long-distance running or ice hockey, are more likely to provoke symptoms than activities with short bursts of effort.
EIA occurs when rapid inhalation of large air volumes, especially cold and dry air, causes airways to lose water and heat. This dehydrates airway cells, releasing inflammatory mediators. These mediators then cause smooth muscles around the airways to contract, narrowing air passages and making breathing difficult.
EIA diagnosis involves a medical evaluation, including symptom and history review. A healthcare provider may perform lung function tests, like spirometry, before and after an exercise challenge. During the challenge, an individual performs activity intense enough to trigger symptoms, and lung function is measured to confirm the diagnosis.
Pathways to Improvement or Remission
While a complete “cure” for underlying asthma is uncommon, EIA can enter remission, where symptoms are significantly reduced or absent during exercise. Effective management allows individuals to participate in physical activities without significant limitations.
Factors influencing improvement or remission include age; children may appear to “outgrow” EIA as their respiratory systems mature. While asthma is lifelong, some children experience fewer symptoms with age, especially if initial wheezing was linked to respiratory infections.
The severity of underlying asthma impacts EIA’s trajectory. Well-controlled asthma often leads to improved EIA symptoms. Poorly managed asthma can result in more persistent and severe EIA. Adherence to prescribed treatments, even for mild symptoms, contributes to better long-term control and reduced EIA episodes.
Environmental factors also impact symptom severity. Reducing exposure to triggers, like avoiding outdoor exercise on high pollen or polluted days, lessens EIA attacks. Lifestyle adjustments, including maintaining a healthy weight and improving fitness, can contribute to better respiratory health and reduced EIA symptoms.
Effective Management Strategies
Effective EIA management combines pre-exercise preparations and activity adjustments. A 15 to 20-minute warm-up, including dynamic stretching and light calisthenics, prepares airways and reduces symptom onset.
Using a rescue inhaler (e.g., SABA) 15 to 30 minutes before exercise is an effective preventive measure. These medications relax airway muscles, keeping them open. For persistent symptoms or underlying asthma, a healthcare provider might prescribe long-term controller medications, like inhaled corticosteroids, to reduce inflammation.
Environmental adjustments also reduce symptoms. In cold, dry air, wearing a scarf or mask warms and humidifies inhaled air, making it less irritating. Avoiding outdoor exercise during high pollen or pollution prevents triggers from worsening symptoms.
Selecting appropriate exercise types minimizes EIA symptoms. Short-burst activities, like baseball or weightlifting, are often better tolerated than continuous, high-intensity sports. Swimming in a warm, humid environment is often well-suited, though chlorine sensitivity should be considered. Working with a healthcare provider to tailor an exercise plan and medication regimen optimizes symptom control and ensures continued physical activity.