What is exercise-induced asthma?
Asthma is a chronic (long-lasting) lung disease in which the
lining of the airways of the lungs is often swollen or inflamed.
It causes wheezing, coughing, shortness of breath, and chest
tightness. Exercise-induced asthma is a form of asthma that some
children have during or after physical activity.
How does it occur?
When a child has asthma, the muscles around the airways tighten
and the lining of the airways swells and produces thick mucus.
This causes the airway to narrow and makes it harder to breathe.
This breathing difficulty is called an asthma attack. In
exercise-induced asthma, this can occur:
- during or after vigorous physical activity
- when the air is cold
- when the humidity is very low or high
- when there is a lot of air pollution
- when there are a lot of allergens in the air.
For many children, running or bicycling in the cold air may
trigger symptoms. Crying and temper tantrums may also trigger an
asthma attack in very young children.
What are the symptoms?
The symptoms of exercise-induced asthma include:
- wheezing (a high pitched whistling sound heard during
breathing)
- coughing with exercise
- shortness of breath
- chest tightness
- fatigue
- new or increased reluctance to participate in vigorous play or
activities requiring physical exertion
How is it diagnosed?
Your healthcare provider will ask about your child's history of
breathing problems during or after exercise. He or she may ask
your child to run on a treadmill or to exercise outside the
office. After that the healthcare provider will then listen to
your child's lungs with a stethoscope to check for wheezing after
the exercise.
Your healthcare provider may give you a small device called a
peak-flow meter. This measures the fastest speed your child can
blow air out of his lungs after a deep breath. During a bout of
exercise-induced asthma, the peak flow measurement will decrease
from your child's normal measurement.
How is it treated?
Exercise-induced asthma can be successfully treated with medicine.
The kind of medicine usually tried first is an inhaled
bronchodilator such as a short-acting beta2-agonist. This is also
called a "quick relief medicine." Examples of these medicines are
albuterol and pirbuterol. They work fast to relax the muscles of
the airways. They prevent tightening of the muscles around the
airways (bronchospasm) caused by exercise, cold air, and air
pollutants. This kind of medicine is used to treat acute asthma
attacks. They may be given 15 minutes before exercise to people
with exercise-induced asthma in order to prevent symptoms.
Other preventative medicine, such as cromolyn, may be prescribed.
This can be taken 15 minutes before exercise or exposure to cold
air or allergens to prevent symptoms. Cromolyn can help prevent
exercise-induced asthma, but will not help like albuterol or
pirbuterol will after your child has started wheezing.
How can I take care of my child?
If your child has exercise induced asthma, let coaches, teachers,
or others who supervise your child's activities know what to do to
help your child. Exercise and other physical activities do not
routinely need to be avoided. If your child is recovering from a
viral illness and needs a few days to fully recover, he may need
to avoid gym class or sports for a short time. Your child can
usually avoid symptoms by using a quick-relief medicine 15 to 30
minutes before exercise. If your child takes a quick-relief
medicine before exercise and does not recover quickly from asthma
symptoms, repeat the dose after exercise is stopped. If your child
regularly has a lot of symptoms with exercise even after using a
quick relief medicine, talk with his healthcare provider.
Some children have more symptoms during strenuous activity in
cold, dry air. During the winter your child may need to exercise
indoors or wear a mask when exercising outside. Wearing a mask
warms the air before your child inhales it. You may also need to
be aware of conditions such as air pollution or allergens such as
dust or pollen.
Doing warm-up exercises before a vigorous workout may help prevent
an exercise-induced asthma attack.
When should I call my child's healthcare provider?
Call IMMEDIATELY if your child:
- has severe wheezing
- is having trouble breathing
- has wheezing that has not improved after the second dose of
asthma medicine
- has a peak flow rate of less than 50% of the personal best.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
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