Could You Have Exercise-Induced Asthma? BY BARBARA A.

IS ENDURANCE EXERCISE difficult for you? Do you wonder how your friends can carry on a conversation while working out? Are you simply out of shape? You may have exer­cise-induced asthma (ETA). Up to one in five people without chronic asthma experience asthma-like symptoms during or immedi­ately following exercise. People often fail to realize that they have ETA because the symp­toms mimic the normal fatigue and breath­lessness associated with intense exercise.

Symptoms of exercise-induced asthma

The most common symptoms of ETA include the following. These may be expe­rienced either during or after exercise, or both:

• Shortness of breath — you may stifi feel breathless up to 10 minutes after exercise

• Chest tightness

• Excess mucus production during exercise

- Wheezing, a whistling or rasping sound while breathing

• Coughing, or feeling the need to clear your airways

Less common symptoms include the following:

• Excessive fatigue with exercise feel­ing out of shape at workloads that should not elicit such fatigue

- Lower performance than would be expected with current training levels

• Sore throat with exercise

• Headache

• Stomach cramps

EIA, or just out of shape?

Your healthcare provider can give you a lung function test with an instrument called a spirometer to see if you have EIA. A spirometer measures how much air you are able to forcefully exhale in one second. You can take this simple test at rest, and then again after some kind of breathing chal­

lenge, such as fast breathing or an exercise test. If your post-challenge value is signifi­cantly (usually 10 percent or more) lower than your resting value, ETA is diagnosed.

How is ETA different from regular asthma?

Some researchers believe that ETA (they might call it exercise-induced bronchocon­striction) does not always involve as much inflammation as other forms of asthma. But others feel it’s all the same, just with dif­ferent triggers. About 90 percent of people who experience chronic asthma find that exercise also triggers asthma attacks. Many people with ETA also have allergies.

Everyone agrees that people should be treated on an individual basis, according to the severity of their symptoms and which triggers provoke asthma symptoms.

Any condition that causes difficulty breathing should be taken seriously. Although most asthma attacks respond well to medication, every year, many people are rushed to the hospital with breathing diffi­culties resulting from asthma. Some people, including athletes, even die from asthma. Almost 5,000 asthma deaths occur in the United States each year.

Why does exercise cause asthma symptoms?

No one knows exactly why exercise trig­gers asthma symptoms. Some researchers believe it has to do with the changes in the airways that occur with heavy breathing. Normally, the nose humidifies and warms inhaled air before it reaches the airways. As exercise becomes more intense, you breathe through your mouth instead of through your nose. Large volumes of dry; cool air draw moisture from the airways. As the air­ways lose moisture, chemical changes in the cells may trigger the allergic reactions asso­ciated with asthma.

How is ETA treated?

A variety of asthma medications help prevent symptoms of ETA. These must be individually prescribed by your doctor. People with allergies may also be able to avoid conditions that exacerbate their asthma. For example, people allergic to pollen may have less ETA when they exer­cise indoors during pollen season. Many people with asthma find that respiratory infections (colds, flu) trigger asthma symp­toms. You may need to avoid intense or endurance exercise when you are sick.

Some types of exercise may be easier for you. Stop-and-start activities, such as team sports and racquet sports, may be less prob­lematic. Exercise in cold, dry air tends to be more challenging, although wearing a facemask designed for cold-weather exercise may reduce breathing discomfort. Swim­ming in a warm, humid environment is comfortable for many people with ETA. ‘~

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