Do you cough, wheeze and have a tight chest or shortness of breath when you exercise? If yes, you may have exercise-induced asthma.
Asthma is a breathing disorder that may have various triggers, such as exercising or increased physical activity. Exercise-induced asthma is a subtype of asthma whereby the person may develop an asthma attack during or after an exercise. The healthcare professionals usually call it exercise-induced bronchoconstriction (EIB).
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EIB occurs in 10% of the general population and up to 90% of patients with asthma. It is more common in persons who participate in sports requiring high ventilation rate such as running and cycling.
Symptoms of EIB
Similar to any other asthma attack, the symptoms of EIB include cough, wheezing, breathlessness or chest tightness. They occur during or after strenuous exercise and usually peak 5 - 10 minutes after exercise.
What triggers EIB?
People with EIB are very sensitive to both low temperatures and dry air. Air is usually warmed and humidified by the nose, but during strenuous activity people breathe more through their mouths. This allows cold, dry air to reach their lower airways and lungs without passing through the nose, thus triggering asthma symptoms. Other asthma triggers may also be at play here, such as pollens, air pollutants or viral respiratory infections.
How to prevent EIB?
Although asthma patients need to take a few extra precautions while exercising, they should still get regular exercise. This is because exercise is important for lung health and improved asthma control in adults. With the right approach, they can reap the benefits of exercising without developing an asthma attack. Therefore, we hope the following tips can help asthma patients to feel more confident about getting active.
Take your inhaler as prescribed
If you think you might have EIB, consult a doctor and develop a treatment plan. Generally, the treatment for patients with EIB is a regimen of inhalers, which may consist:
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A daily dose of inhaled corticosteroids (ICS) and/or taking salbutamol inhaler (usually blue in color) 15 to 20 minutes before carrying out strenuous activity; OR
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Taking ICS-formoterol combination inhaler before strenuous activity
Inhaled corticosteroids (ICS) is what we call a preventer inhaler. It does not relieve asthma symptoms immediately, but taking it long-term is crucial to a good control of asthma, as it helps to reduce inflammation in the lungs.
Budesonide is an example of inhaled corticosteroids (ICS).
Whereas salbutamol inhaler is a reliever, which you take when you develop asthma symptoms or before you do exercise. Salbutamol provides instant relief by opening up your airway, but it should pair with an ICS for a good management of asthma.
Ventolin inhaler, whose active ingredient is salbutamol.It is a reliever inhaler. Image credit: MIMS Indonesia
These inhalers may have different active ingredients, ways of taking and price, so explore various options with your doctor and pharmacist.
Find the right activity for you
Staying physically active doesn’t mean that you need to sign up for a marathon. Taking a daily stroll, doing some gardening or playing more vigorously with children still count. Milder physical activities may be suitable for you, such as walking, yoga, tai chi and hiking. It’s also important that you warm up thoroughly before starting any exercise.
Follow asthma safety tips
It’s crucial you know what to do if your asthma gets worse while exercising.
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Coughing, wheezing, and breathlessness are all signs that you need to stop and take your reliever inhaler. It’s normal to breathe faster after exercise, but if you’re unusually breathless or your breathing isn’t calming down after you stop, it’s a sign you might be having an asthma attack.
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Tell people you exercise with that you have asthma, and explain what to do if you have an asthma attack.
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Get to know your good days and bad days, and your personal triggers like pollen, dust or heat. It’s OK to let yourself off and rest.
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Cold weather can set off your symptoms, so wrap a scarf round your face and nose if you’re going outside on a chilly day, or consider sticking to indoor activities that day instead.
A word from DOC2US
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Specific references have been linked in its relevant part of the article.
References
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Asthma UK - Getting active when you have asthma
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Global Initiative for Asthma (GINA) - Global Strategy for Asthma Management and Prevention, 2021. Available from: www.ginasthma.com
Cover image credit: DrWeil
