Exercise-induced asthma affects athletes of all calibers
If your child has asthma and he huffs and puffs during or after exercising he might have exercise-induced asthma. Exercise-induced asthma occurs when asthma symptoms are brought on by exercise. EIA is not an uncommon disease, occurring in 10 to 14 percent of all children.
Children and adolescents who have persistent asthma usually suffer from EIA as a part of their disease. Still, many children and parents don’t recognize the symptoms of EIA and the condition is frequently under-diagnosed and under-treated by physicians.
In undiagnosed children, EIA can lead to a reduction in physical activity. Children may stop exercising because they find it hard to breathe or because they are afraid of the symptoms. But when EIA is successfully managed, children can participate in sports and exercise. They can even excel – it is estimate that as many as 20 percent of Olympic athletes have EIA. Studies have shown that when asthmatics become more physically fit, EIA symptoms are reduced.
EIA is not a different disease than asthma. It is only one symptom, and may in fact be the only symptom, of the disease. EIA may be an indication that a patient’s asthma is not under control and more preventive medication needs to be taken.
Symptoms
The symptoms of EIA are the same as those of an asthma attack. The most common symptoms are wheezing, coughing, tightness in the chest, shortness of breath and difficulty breathing. EIA may be confused with poor fitness, lack of endurance, or a lack of interest in sports or other physical activity. Certain exercises are better-suited for children with EIA. These include sports and activities that involve short bursts of energy such as golf and baseball. Walking and recreational swimming are also good choices. Activities that require long periods of exertion, such as long distance running, soccer and basketball, can be more difficult for children with EIA.
In some patients, exercise may be the only trigger of asthma. Symptoms may not occur if exercise is for very short periods of time. EIA symptoms occur most frequently after 5 to 12 minutes of exercise. The symptoms usually are completely cleared up after 1 hour. A second episode of symptoms may occur 3 to 8 hours later in some patients.
Diagnosis
The biggest problem in diagnosing EIA is differentiating those children and adolescents who just don’t like to exert themselves because of lack of interest or because they are out of shape. This has become more difficult with the increase in sedentary activities in children (computers, video games and television) and rising rates of overweight and obese children.
Every child with EIA should be evaluated for persistent asthma. Up to 90 percent of children with asthma may have EIA. The most common trigger for asthma in children is exercise. The diagnosis can be missed when a child has a very sedentary lifestyle or when the child just doesn’t like physical activity. A trial on a short-acting inhaled bronchodilator before exercise or right after exercise will frequently confirm the diagnosis if symptoms are prevented or clear up after the medication is given. If bronchodilators do not help, another cause may have to be sought.
In a doctor’s office the diagnosis is made by doing an exercise challenge test using a spirometer, a device used to assess lung function by measuring how much air is exhaled.
Management
EIA can be affected by the type and duration of exercise, temperature, humidity or other asthma triggers such as pollens and pollutants. Inadequate medication for controlling asthma or lack of pretreatment with bronchodilator medications can also trigger EIA.
The first step in managing EIA is treating the underlying persistent asthma, if it exists. If EIA is still present, medications such as bronchodilators can be taken before or after exercise to reduce symptoms. Since these medications are effective for several hours, most children can be treated before the school day and remain symptom-free through physical education classes and recess.
Prevention
With proper treatment and prevention methods, many children and adolescents with EIA can attain a normal level of activity. Your child can prevent or minimize EIA symptoms by:
- Using medication(s) as prescribed by your doctor
- Stretching or warming-up for 10-15 minutes before exercise
- Beginning exercise slowly for an additional 10 to 15 minutes.
- Using fast-acting bronchodilator as soon as wheezing or coughing begins
- Wearing a scarf or facemask over his mouth and nose to warm the air that is inhaled. These screens are also helpful when pollen and pollution levels are high
- Staying hydrated by drinking fluids before, during and after exercise
- Completing exercise with a cool-down period, such as stretching or jogging
Michael P. Pacin, MD, FAAAAI, is an allergist/immunologist based in Miami, Florida. The American Academy of Allergy, Asthma & Immunology is the largest professional medical association devoted to the research and treatment of allergic disease. The AAAAI offers educational materials for patients online at www.aaaai.org.
View Full Article
Reprinted with the permission of the American Academy of Allergy Asthma & Immunology. © 1996-2008 American Academy of Allergy Asthma and Immunology. All Rights Reserved.
10 Ways to Spice Up Your Barbecue
Summer Reading
Happy Graduation
Add your own comment