Breathe Right During Exercise

Bronchoconstriction induced by exercise guidelines released to diagnose and treat condition

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Athletes and active individuals who don't have asthma can still develop troubles breathing when exercise is involved. New official guidelines to diagnose and manage exercise-induced bronchoconstriction (EIB) have been released.

These guidelines can help patients take care of troubles breathing during exercise and prevent the condition from starting.

Under these guidelines, EIB is diagnosed by looking at changes in lung function caused by exercise rather than looking at people's symptoms.

"Talk to a specialist about breathing issues."

The recommendations, written under the direction of Jonathan Parsons, MD, associate professor of internal medicine and associate director of the Ohio State University Asthma Center, cover diagnosis and treatment guidelines reflecting new research on bronchoconstriction

The guidelines were written in accordance with the American Thoracic Society's standards for clinical practice.

Lung function is measured using forced expiratory volume (FEV), which is how much a person can exhale as much as possible. This measurement is taken after a specific exercise or hyperventilation.

FEV is also used to determine the severity of the condition. Severity can be categorized as mild, moderate or severe.

Mild exercise-induced bronchoconstriction is defined as having between 10 and 25 percent decrease in FEV under the guidelines.

A drop in FEV between 25 and 50 percent is classified as a moderate case of exercise-induced bronchoconstriction and more than 50 percent drop is considered a severe case of the condition.

To treat the condition, the guidelines recommend that patients receive an inhaled short-acting beta-antagonist at least 15 minutes before exercise. Individuals should also engage in an interval or combination warm-up.

Doctors can add a controller agent or inhaled corticosteroid if the first inhaler is used daily or more than once a day. Daily use of long-acting beta-antagonist  is not recommended under the guidelines, nor is taking the corticosteroid before exercise.

Inflammatory medicines such as leukotriene receptor antagonists and other antihistamines like mast cell stabilizing agent are highly recommended.

An antihistamine could be administered to individuals with EIB and allergies. Those who exercise in cold weather could routinely use a mask or other device that warms and humidifies the air during exercise.

Other guidelines address dietary modifications to ease symptoms, including lowering salt intake and taking more fish oil and ascorbic acid supplements.

The guidelines were published May 1 in the American Journal of Respiratory and Critical Care Medicine.

Reviewed by: 
Review Date: 
April 29, 2013
Last Updated:
November 6, 2013