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Exercise-Induced Bronchoconstriction

After exercising for 5 to 10 minutes:

  • Do you begin to cough?

  • Does your chest feel tight or you feel chest pain?

  • Do you have trouble breathing or wheezing?

  • Do you have shortness of breath?

If you answered yes to one of the questions above, you may have exercise-induced bronchoconstriction (EIB). EIB, sometimes called exercise-induced asthma, is a sudden narrowing of the airways (tubes that bring air in and out of the lungs) when you exercise. Exercise can make symptoms worse in most people who have asthma.

However, people who don’t have asthma may also have symptoms of asthma with exercise. EIB can occur in healthy athletes who don’t have asthma, or people who have allergies. 

Triggers

Woman running along a path in cold weahter

The cause of EIB is not completely understood. Breathing in cold, dry, or polluted air is a primary reason or factor. During exercise, more air enters the lungs through the mouth, instead of the nose. The air isn’t warmed or moistened like air entering the nose. The colder, dryer air causes the airways to narrow.

In addition to asthma, other risk factors for EIB include:

  • Sensitivity to cold, dry, or polluted air

  • Not being in shape or not used to exercise

  • Poorly-controlled allergies, especially nasal

  • Vocal cord problems or issues

  • High pollen levels

  • Respiratory infection (viral)

Symptoms

If you have EIB, you may have symptoms within minutes of starting to exercise. The symptoms are the same as asthma symptoms.

They may include:

  • Shortness of breath

  • Wheezing or whistling sound with breathing

  • Tightness in the chest

  • Cough

  • Chest pain (uncommon)

The diagnosis

During your office visit, your healthcare provider will ask about your medical history. You will also have a physical exam. You may have testing of how well your lungs work. The most common test is spirometry and your breathing will be checked at rest. Your breathing may also be checked several times while exercising (called an exercise-challenge test).

Your healthcare provider may recommend medicine before or during exercise. An inhaled medicine (such as albuterol) is often used. This type of medicine is called a rescue or quick-relief medicine. Rescue medicines are used about 15 minutes before exercising. They may also be taken again during or after exercise, if needed.

If you have asthma, you may already use controller medicines. If you don’t already use controller medicines, your healthcare provider may prescribe one for you. He or she may want you to take it if rescue medicines are not working. Controller medicines are taken regularly to help prevent symptoms. Inhaled steroids are commonly used. They are the preferred controller medicines.

Managing the condition

Living with EIB doesn’t mean you need to give up exercise. Exercise is important for overall good health and for keeping your lungs and muscles used for breathing strong. Your body needs exercise. Work with your healthcare provider to exercise safely and with as few symptoms as possible. Most people who have EIB can exercise safely. Make sure you:

  • Talk with your provider about what exercise is safe for you.

  • Take medicines before exercising, if prescribed for you and as prescribed by your provider.

  • See your healthcare provider if your symptoms are getting worse or happening more often.

  • Ask your healthcare provider, nurse, or pharmacist how to correctly use an inhaler or medicines, if prescribed for you and as prescribed by your provider.

What you can do

In addition to taking medicines, there are things you can do to prevent or lessen symptoms of EIB. These include:

  • Don’t exercise outside on cold, dry days. If you are outside in cold weather, cover your mouth with a special mask or scarf.

  • Don’t exercise outside on days when there is a lot of pollen or air pollution. Instead, exercise indoors.

  • Don't smoke.

  • If you haven’t been exercising, but are going to start, do it slowly. Slowly increase how hard and how long you exercise.

  • When exercising, make sure you always warm up and cool down.

  • Try different activities and figure out the best one for you.

  • Take breaks and drink water before, during, and after exercising.

When to call your healthcare provider

Call your healthcare provider right away if:

  • You are taking medicines for EIB and you are still having symptoms such as:

    • chest tightness

    • trouble doing normal activities

    • breathing fast

  • You have any questions about your medicines or exercise activities

Asthma from any cause that is not controlled can be very serious. It can be life-threatening. Emergency room treatment and hospital stays may be needed. EIB can get in the way of athletes’ ability to take part in sporting events. Exercise is important and provides many health benefits, especially for people with asthma. So don’t give up on an active lifestyle.

Call 911

Call 911 right away if:

  • You are having trouble breathing, breathing fast, or shortness of breath

  • You are having trouble talking or speaking

  • Your inhaler is not working and symptoms are worse

  • You feel drowsy

  • Your finger or lips are turning blue or gray (pale)

  • Your peak flow is worse after a treatment or as determined by your provider and asthma action plan

Online Medical Reviewer: Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC
Online Medical Reviewer: Pierce-Smith, Daphne, RN, MSN, CCRC
Date Last Reviewed: 11/1/2016
© 2000-2018 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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