Risk factors and complications
Elite athletes and those with asthma are more prone to have exercise-induced bronchoconstriction. Although exercise-induced bronchoconstriction can occur in anybody, it is more prevalent in elite athletes. Exercise-induced bronchoconstriction affects around 90% of persons with asthma. However, the disease can also develop in persons who do not have asthma. Air pollution, chemicals from ice cleaning equipment, dry air, activities requiring lengthy periods of deep breathing, and cold air are all factors that might raise the risk of the disease or function as triggers. It was earlier assumed that cold air complicated exercise-induced asthma; however, studies showed that air humidity has a major role in triggering this condition more than the air temperature. Since cold air is low in moisture than warm air, breathing cold, dry air rapidly dehydrates bronchial tubes, narrowing the airways and restricting airflow. Exercise-induced bronchoconstriction, if left untreated, can lead to a worse quality of life due to incapability to exercise and severe or life-threatening breathing problems.
Diagnosis and treatment
A doctor will do a physical exam and prescribe tests to evaluate the lung function and rule out other diseases that might be causing the symptoms. Bronchodilator medicines help the doctor examine a person after taking an inhalation medicine to open their lungs. Then the doctor compares two sets of results with and without bronchodilators to evaluate if the bronchodilator improved the airflow. A doctor will most likely do a spirometry test to see how well the lungs work while a person is not exercising. A spirometer monitors how much air a person intake, how much they exhale, and how fast they exhale. An activity challenge is another test that allows the doctor to examine symptoms. A treadmill or other stationary exercise equipment is also used to raise the respiratory rate. This activity should be vigorous enough to cause discomfort. If necessary, a person is requested to do a real-life workout challenge, such as stair climbing. Spirometry tests performed before and after the challenge can reveal exercise-induced bronchoconstriction.
Treatment involves two types of medication therapies. They are as follows:
Pre-exercise medications: A doctor may prescribe medications immediately before exercise or regularly for long-term management.
If a doctor recommends a medication to take before exercise to reduce or avoid exercise-induced bronchoconstriction, find out how much time a person needs between taking the prescription and exercising.
Short-acting beta-agonists are inhaled medications that assist open airways. These are the most widely utilized and, in most cases, highly effective pre-exercise medicines. However, using these drugs daily is not advised since a person may build a tolerance to them. Albuterol and levalbuterol are some examples.
Ipratropium is helpful to relax the airways, and this is an inhaled medicine. A nebulizer is also used to provide a generic form of ipratropium.
Control medicines for the long-term: When pre-exercise therapy alone is ineffective, a doctor may give a long-term control medication to manage underlying chronic asthma or reduce symptoms. These medicines, which are generally used daily, are as follows:
Inhaled corticosteroids, which aid in the suppression of inflammation in the airways. This therapy may need to be used for up to four weeks before it is effective.
Corticosteroids and a long-acting beta-agonist are medications that help relax the airways, are used as inhalers. While these inhalers are intended for long-term use, a doctor may advise a person to use them before exercise. Some patients benefit from leukotriene modifiers, which are oral medicines that inhibit inflammatory activity. These medications are used daily. Montelukast (Singulair), zafirlukast (Accolate), and zileuton are a few examples (Zyflo).
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