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Exercise-induced asthma : Causes - Symptoms- Diagnosis -Treatment


 What Is Exercise-induced asthma (EIA)?

Exercise-Induced Bronchoconstriction (Asthma)

Everyone has to exercise, even folks with asthma! A powerful, healthy body is one of your best defenses against unwellness. however some folks with respiratory illness|respiratory disease|respiratory illness|respiratory disorder} has asthma episodes throughout exercise. With the correct bar and management, you must be ready to exercise free from symptoms.

What Is Exercise-induced asthma (EIA)?
Exercise-induced asthma

  1. Respiratory system

    1. Nasal cavity

    2. Pharynx

    3. Larynx

    4. Trachea

    5. Bronchioles and smaller air passages

    6. Lungs

    7. Muscles of breathing

Medical terms

  • Exercise-induced bronchial asthma could be a narrowing of the airways within the lungs triggered by strenuous exercise. It causes shortness of breath, wheezing, coughing, and alternative symptoms throughout or when exercise.

  • The preferred term for this condition is exercise-induced bronchoconstriction .This term is a lot of correct as a result of the exercise-induced narrowing of airways (bronchoconstriction) however is not a root reason behind bronchial asthma. Among folks with bronchial asthma, exercise is probably only 1 of many factors that may trigger respiratory difficulties.

  • Most people with exercise-induced bronchoconstriction will still exercise and stay active by treating the symptoms with bronchial asthma medications and taking preventive measures.

  •  Bronchial asthma is outlined as a chronic inflammatory disorder of the air passages within which several cellular parts play a job, namely, mast cells, eosinophils, neutrophils, animal tissue cells, T lymphocytes and macrophages. In prone people this inflammation ends up in redoubled responsiveness of the tracheobronchial tree to a multiplicity of stimuli.

  • This is manifested physiologically by a widespread narrowing of the air passages which can be eased ad lib or as a result of medical care and is clinically characterized by paroxysms of symptom, cough and wheeze. it's Associate in Nursing episodic illness, acute exacerbations being interspersed with symptom–free periods.

  • Exercise-induced bronchial asthma|respiratory disease|respiratory illness|respiratory disorder} (EIA) is an Associate in Nursing asthma variant which can be outlined as a condition within which exercise or vigorous physical stress triggers acute spasm in folks with redoubled airway reactivity. it's primarily seen in United Nations agency|people that|folks that|those that|Those who} square measure wheezy however also can be found in patients who have allergic reaction or rhinitis and even in healthy people.

  • Exercise-induced bronchial asthma|respiratory disease|respiratory illness|respiratory disorder} is even additional vital to the chest specialist as a result of it's a neglected diagnosis and therefore the underlying asthma may be silent in as several as five hundredth of patients,1 turning into apparent solely throughout exercise.

  • Exercise-induced respiratory disease (EIA) could be a common condition moving 12-15% of the population. Ninety % of wheezy people and 35-45% of patients with rhinitis square measure afflicted by EIA, whereas 3-10% of the final population is additionally believed to suffer from this condition. EIA could be a condition that is additional rife in strenuous out of doors, weather and winter sports. The pathophysiology of EIA continues to intrigue medical physiologists. However, the water-loss hypothesis and therefore the post-exertional airway-rewarming hypothesis square measure till now the most effectively accepted theories. EIA is best diagnosed by a decent anamnesis and a free-run challenge check. A post-exertion decrease by V-J Day in FEV1 and PEFR is diagnostic of EIA. Sensitivity of exercise testing ranges from fifty fifth to eightieth whereas specificity is as high as ninety three. EIA could be a disorder that may be treated with success by combining each non-pharmacological and medical specialty treatment choices. Prompt diagnosing and treatment of this condition is significant if we tend to hope to supply our patients with higher overall health.


EIA affects 12-15% of the population. Ninety % of unhealthy people and 35-45% of patients with hypersensitivity reaction expertise EIA, however even once this cluster of patients is excluded, a 3-10% incidence of EIA is seen within the general population.2

EIA appears to be prevailing in some winter and cold-weather sports.3 Some studies have incontestable rates as high as three5% or perhaps five hundredth in competitive-caliber figure skaters, hockey players, and cross–country skiers. 

Symptoms Exercise-induced asthma (EIA)

Signs and symptoms of exercise-induced bronchoconstriction usually begin during or soon after exercise. These symptoms can last for 60 minutes or longer if untreated. The signs and symptoms can include:

  • Coughing

  • Wheezing

  • Shortness of breath

  • Chest tightness or pain

  • Fatigue during exercise

  • Poorer than expected athletic performance

  • Avoidance of activity (a sign primarily among young children)

When to see a doctor

See your doctor if you've got signs or symptoms of exercise-induced bronchoconstriction. a variety of conditions will cause similar symptoms, creating it necessary to urge a prompt and correct identification.

Get emergency medical treatment if you have:

  • Shortness of breath or wheezing that is quickly increasing, making it a struggle to breathe

  • No improvement even after using a prescription inhaler for asthma attacks

Causes Exercise-induced asthma (EIA)

It's not clear what causes exercise-induced bronchoconstriction. There could also be over one process concerned. individuals with exercise-induced bronchoconstriction have inflammation and would possibly manufacture excess mucous secretion once onerous exercise.

When you exercise, you breathe quicker and deeper because of the exaggerated element demands of your body. you always inhale through your mouth, inflicting the air to be appliance and cooler than once you breathe through your nose. The dry and/or cold air is the main trigger for airway narrowing (bronchoconstriction). Exercise that exposes you to cold, dry air is additional seemingly to cause respiratory illness symptoms than exercise involving heat and wet air. alternative triggers which will create EIB symptoms worse: 

  • Pollution levels

  • High pollen counts

  • Exposure to other irritants, such as smoke and strong fumes

  • A recent cold or asthma episode

Risk factors Exercise-induced asthma (EIA)

Exercise-induced bronchoconstriction is more likely to occur in:

  • People with asthma. About 90% of people with asthma have exercise-induced bronchoconstriction. However, the condition can occur in people without asthma too.

  • Elite athletes. Although anyone will have exercise-induced bronchoconstriction, it's a lot common in high-level athletes.
    Factors that may increase the danger of the condition or act as triggers include: 

  • Cold air

  • Dry air

  • Air pollution

  • Chlorine in swimming pools

  • Chemicals from ice cleaning equipment

  • Activities with extended periods of deep breathing, such as long-distance running, swimming or soccer

Complications Exercise-induced asthma

If not treated, exercise-induced bronchoconstriction can result in:

  • Serious or life-threatening breathing difficulties, particularly among people with poorly managed asthma

  • Lower quality of life because of inability to exercise

Can you fix exercise-induced asthma?

Yes you can fix exercise-induced asthma with a proper warm up and cool down This will help to prevent against exercise-induced asthma attacks The breathing exercises that follow are beneficial for anyone who wants to reduce their incidence of asthma symptoms They focus on breathing normally through the nose while exercising at maximum heart rate (220 beats per minute) but they can be tailored to fit any aerobic routine This is recommended to do 3 times a day every other day until your symptoms have subsided completely.

How do you overcome exercise-induced asthma?

Exercise-induced asthma is the most common form of asthma and can be brought on by any kind of physical activity however it is typically triggered by exercise This condition is a temporary narrowing of airways in the lungs that makes breathing difficult or impossible Exercise-induced asthma symptoms include wheezing coughing and difficulty breathing While it's completely normal to experience shortness of breath when you begin exercising after not doing so for a while this shouldn't last more than a few minutes If it does you're likely experiencing exercise-induced asthma In some cases exercise-induced asthma may lead to an asth.

How long does exercise-induced asthma last?

Exercise-induced asthma or EIA arises from a combination of physical activity and exposure to cold dry air There are two types of exercise--intense aerobic exercise (running) and intense anaerobic exercise (weight lifting) It’s typically not associated with everyday activities such as walking or cleaning the house The condition can occur in any warm-blooded animal that uses lungs for breathing.

How do you get rid of exercise-induced bronchospasm?

Exercise-induced bronchospasm is the condition in which breathing difficulties occur during or after exercise The dangers of this condition are not limited to those who already suffer from asthma Anybody can experience exercise-induced bronchospasm regardless of whether they have any history of lung disease In most cases people notice shortness of breath and wheezing as a result of exercising hard In some cases though patients may experience chest pain that is experienced even when resting and not in conjunction with physical activity These symptoms typically arise within 10 minutes post-exercise but may occur up to 24 hours later.

What happens if exercise-induced asthma is left untreated?

Exercising is widely recommended for asthma patients to help stave off attacks but it can also contribute to them The positive and negative effects of exercise on asthma are related to the level of activity but most often starting and stopping asthma attacks have a direct correlation with physical activity When an asthmatic person exercises medication that prevents bronchospasm (closing of the airways) from happening isn't necessary However if he or she has exercise-induced asthma continuing beyond mild symptoms can hinder lung function by triggering bronchoconstriction (airway narrowing) If a patient's illness is severe enough.

Can you get rid of exercise-induced bronchoconstriction?

Yes EIB is often associated with exercise-induced asthma which can be treated in several ways including the use of a metered-dose inhaler or an inhalant rescue medication (such as albuterol) The underlying cause should be determined and properly treated to prevent the bronchospasm from recurring.

What exercise-induced asthma feels like?

Many people have mild bouts of exercise-induced asthma They may notice a few things after they work out: They become more aware of their breathing They may also breathe through the mouth instead of the nose causing them to lose some of the ability to exhale all the stale air from their lungs They will wheeze and cough when they get up too fast or exert themselves Many develop shortness of breath which can cause them to worry about getting enough oxygen into their bodies Some experience tightness in their chests and rib cages at times so bad it keeps them from doing anything vigorous for fear something awful.

Diagnosis Exercise-induced asthma (EIA)

It is vital to understand the distinction between being out of condition and having EIB. to form a designation, your doctor can take a radical history and should perform a series of tests. Your doctor can live your respiration before, throughout and once exercise to check your respiratory organ functions. Then, your doctor can assist you produce an idea thus you'll take steps to stop respiratory illness symptoms and revel in physical activity. Your doctor also will tell you what to try to to ought a full-blown respiratory illness episode occur.

Your doctor can conduct a medical examination and order tests to assess your respiratory organ perform and rule out different conditions which will cause your symptoms.

Test of normal lung function

Your doctor can possibly administer a spirometry (spy-ROM-uh-tree) . Take a look at to assess how well your lungs perform after you are not making an effort. A measuring device measures what quantity of air you inhale, what quantity you exhale and the way you exhale quickly.

Your doctor may need you to repeat the take a look at once you're taking AN inhaled medication to open your lungs (bronchodilator). Your doctor can compare the results of the 2 measurements to check whether or not the medicinal drug improved your flowing. This primary respiratory organ takes a look at is very important for ruling out underlying chronic respiratory illness because of the reason for symptoms.

  1. Pulmonary function test
  2. Bronchoscopy
  3. Nasopharyngolaryngoscopy

Exercise challenge tests

An additional check that permits your doctor to assess symptoms is an associate degree exercise challenge. you'll run on a treadmill or use alternative stationary exercise instrumentation that will increase your respiratory rate.

This exercise must be intense enough to trigger your symptoms. If needed, you would possibly be asked to perform a real-life exercise challenge, like mounting stairs. Spirometry tests before and when the challenge will offer proof of exercise-induced bronchoconstriction.

Alternate challenge test

As an alternative to the exercise challenge, your doctor may use Associate in Nursing inhalation. Take a look at that simulates the conditions that might doubtless trigger exercise-induced bronchoconstriction. If your airways reply to these stimuli, then take a look at ought to manufacture nearly identical respiratory organ operations you have got once exertion.

Spirometry takes a look at before and when the challenge test gives info regarding changes in respiratory organ operation. This challenge takes a look at is often done with victimization medication, Associate in Nursing inhaled agent that causes bronchoconstriction.

Treatment Exercise-induced asthma (EIA)

Your doctor might prescribe drugs to take shortly before exercise or to take daily for long-term control.

Pre-exercise medications

If your doctor prescribes a drug that you just take before exercise to attenuate or stop exercise-induced bronchoconstriction, raise what quantity time you would like between taking the drug and sweat. medication during this cluster include:

  • Short-acting beta agonists, which are inhaled medicine that facilitate open airways. These are the foremost normally used and usually handiest pre-exercise medications. Daily use of those medications isn't suggested, however, as a result you'll be able to develop a tolerance to them. These medicines embody bronchodilator (ProAir HFA, Proventil-HFA, bronchodilator HFA) and levalbuterol (Xopenex HFA).

  • Ipratropium (Atrovent HFA), an inhaled medication that relaxes the airways and may be effective for some people. A generic version of ipratropium also can be taken with a nebulizer.

Long-term control medications

Your doctor might also prescribe a long-term control drug to manage underlying chronic asthma or to control symptoms when pre-exercise treatment alone isn't effective. These medications, usually taken daily, include:

  • Inhaled corticosteroids, which help suppress inflammation in your airways. you may ought to use this treatment for up to four weeks before it'll have most profit. inhaled steroid hormone medications embrace fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler) and beclomethasone (Qvar Redihaler). 

  • Combination inhalers, which contain a steroid and a long beta agonist (LABA), a drug that relaxes airways. whereas these inhalers are prescribed for long-run management, your doctor could advocate use before exercise. Combination inhalers embody fluticasone and salmeterol (Advair Diskus), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera). 

  • Leukotriene modifiers, which are oral medications that block inflammatory activity for a few individuals. These medicines will be used daily or as a preventive treatment before exercise if taken a minimum of 2 hours ahead. Examples embody montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR).
    Potential aspect effects of leukotriene modifiers embody behavior and mood changes and self-destructive thoughts. seek advice from your doctor if you've got these signs or symptoms. 

Don't rely only on quick-relief medications

You can conjointly use pre-exercise medication as a quick-relief treatment for symptoms. However, you mustn't use your pre-exercise inhalator more than your doctor recommends.

Keep a record of what number puffs you employ every week, however typically you employ your pre-exercise inhalator for interference and the way typically you employ it to treat symptoms. If you employ it daily otherwise you ofttimes use it for symptom relief, your doctor would possibly change your long management medication.

  1. lung transplant

Lifestyle and home remedies

Exercise is an important part of a healthy lifestyle for everyone, including most people with exercise-induced bronchoconstriction. Besides taking your medication, steps you can take to prevent or minimize symptoms of exercise-induced bronchoconstriction include the following:

  • Do around 15 minutes of warmup that varies in intensity before you begin regular exercise.

  • Breathe through your nose to warm and humidify the air before it enters your lungs.

  • Wear a face mask or scarf when exercising, especially in cold, dry weather.

  • If you have allergies, avoid triggers. For example, don't exercise outside when pollen counts are high.

  • Try to avoid areas with high levels of air pollution, such as roads with heavy traffic.

At school

If your kid has exercise-induced bronchoconstriction, sit down with your doctor regarding providing an Associate in Nursing action set up. This document provides in small stages directions for lecturers, nurses and coaches that specify what treatments your kid desires, once treatments ought to incline and what to try and do if your kid has symptoms.

Alternative medicine

There is restricted clinical proof that any different treatments profit folks with exercise-induced bronchoconstriction. For instance, it has been suggested that animal oil, ascorbic acid or ascorbic acid supplements will facilitate forestall exercise-induced bronchoconstriction, however there is not enough proof to indicate if they are helpful.

Preparing for your appointment

You're likely to start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in asthma (an allergist-immunologist or pulmonologist).

Be prepared to answer the following questions:

  • What symptoms have you had?

  • Do they start immediately when you start exercising, sometime during a workout or after?

  • How long do the symptoms last?

  • Do you have breathing difficulties when you're not exercising?

  • What are your typical workouts or recreational activities?

  • Have you recently made changes to your exercise routine?

  • Do the symptoms occur every time you exercise or only in certain environments?

  • Have you been diagnosed with allergies or asthma?

  • What other medical conditions do you have?

  • What medications do you take? What is the dosage of each medication?

  • What dietary supplements or herbal medications do you take?

General summary

  1. Exercise-induced asthma (EIA) is a set of symptoms caused by exercise in people who do not have asthma and are otherwise healthy The symptoms include wheezing breathlessness chest tightness coughing and feeling tired These symptoms usually develop 15 to 30 minutes after starting to exercise and improve within an hour or so after stopping EIA affects 5–20% of competitive athletes; these individuals may perform at a lower level than their peers due to the condition In most cases it does not affect athletic performance long term but reduces enjoyment of exercising for those affected Symptoms can be minimized by ensuring a proper warmup.

Exercise-induced asthma  : Causes - Symptoms- Diagnosis -Treatment

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