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Asthma & Exercise-Induced Bronchospasm (Eib)

A chronic breathing disorder characterized by recurrent attacks of wheezing and shortness of breath. It affects many people who exercise regularly.

Exercise-induced bronchospasm (also called EIB) happens when the airways in your lungs shrink (get smaller) while you are exercising. If you have EIB, it can be hard for you to exercise for more than 30 minutes at a time.

Causes

Spasm of air passages (bronchi and bronchioles) followed by swelling of the passages and thickening of lung secretions (sputum). This decreases or closes off air to the lungs. These changes are caused by:

• Allergens, such as some medications, pollen, dust, animal dander, molds and some foods.
• Air irritants, such as smoke, smog and odors.
• Exercise, especially exercise in smoggy or cold air. Bronchospasm can occur within minutes while exercising in cool air. Warm, humid air seldom triggers exercise-induced bronchospasm.
• Lung infections such as bronchitis.
• Stress.
• Family history of asthma or allergies
• Smoking.
• Use of drugs to which you are allergic, such as aspirin.

Signs and symptoms

• Chest tightness and shortness of breath.
• Wheezing when exhaling.
• Coughing, especially at night, with little sputum.
• Rapid, shallow breathing that is easier with sitting up.
• Breathing difficulty- neck muscles tighten.

Severe late symptoms:

• Bluish skin.
• Exhaustion.
• Grunting respiration.
• Inability to speak.
• Mental changes, including restlessness, confusion or delirium.

Diagnosis

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• Laboratory blood studies and pulmonary-function test.
• Chest X-rays.

Treatment

Medical Treatment

• Emergency- room care and hospitalization for severe attacks.
• Psychotherapy or counseling, if asthma stress-related.
• A short-acting bronchodilator, such as albuterol (some brand names: AccuNeb, Proventil, Ventolin), pirbuterol (brand name: Maxair) and terbutaline (one brand name: Brethine). These medications are usually taken 15 minutes before exercise and last 4 to 6 hours. Your doctor will tell you how to take your medicine. It is important to follow your doctor's instructions carefully to make sure your medicine is effective.

Home Treatment

• Eliminate allergens and irritants at home and at work, if possible.
• Keep regular medications with you at all times. Ask your doctor about having emergency drugs available.
• Sit upright during attacks.
• Avoiding exercise in extremely cold temperatures or when pollen levels are high may also help reduce your symptoms.

Medication

Your doctor may prescribe:

• Expectorants to loosen sputum.
• Bronchodilators to open air passages.
• Corticosteroid drugs by nebulizer, which have fewer adverse reactions than oral forms.
• Cromolyn sodium by nebulizer. This is a preventive drug.

Prevention

• Avoid known allergens and air pollutants.
• Take prescribed preventive medicines regularly-don't omit them when you feel well.
• Reduce activity level (sometimes).
• Exercise indoors on smoggy or cold days.