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What Is Exercise-Induced Bronchospasm?

Exercise-induced bronchospasm (EIB) used to be called exercise-induced asthma. The term bronchospasm means tightening and narrowing of the tubes that bring air in and out of your lungs.

Up to 90 percent of people with asthma have EIB. But EIB also affects some people who don’t have asthma and some who have allergies rather than asthma.

If you have coughing, wheezing, or tightness in your chest that begins after you start exercising, you could have EIB. This type of narrowing happens during vigorous exercise because you tend to breathe more through your mouth instead of through your nose. This allows cooler and drier air into your lungs, which can trigger the bronchospasm.

Symptoms of EIB

Symptoms of EIB are most likely to occur if you are exercising outdoors in cold, dry weather. This cold, dry air is usually warmed and moisturized by your nose when you breathe normally. Symptoms of EIB usually begin anywhere from five to 15 or 20 minutes after exercise starts.  These symptoms may include:

  • Wheezing

  • Shortness of breath

  • Tightness in the chest

  • Cough

  • Sore throat

  • Stomachache

  • Tiring quickly during exercise

  • Feeling very tired after exercise

Exercise that lasts longer and/or requires more exertion is more likely to trigger EIB symptoms. Exercising when you are out of shape or when you have a head cold is also more likely to trigger symptoms.

Diagnosing and treating EIB

Your doctor may be able to diagnose EIB by your history and by doing a physical exam. Since most people with EIB do not have symptoms without exercise, you may be asked to exercise and then have your breathing tested.

You may need treatment before and/or during exercise. The first type of drug used is usually a short-acting inhaler such as albuterol (Ventolin). These types of inhaler medications are sometimes referred to as "rescue medications." They are taken about 15 minutes before exercise starts and repeated during or after exercise, if needed.

If you have more severe asthma or if rescue medications are not working, you may need to take a "controller medication." This type of asthma medication is taken regularly to help keep your lungs open. Examples of controller medications include inhaled steroids and medications taken by mouth to prevent bronchospasm.

Living with EIB

The goal of managing EIB is to allow you to keep exercising as normally as possible. That means working with your doctor to find the treatment plan that works best for you. Here are some other tips to help keep you exercising safely with EIB:

  • Avoid exercising outside on cold, dry days. If you are outside in cold weather, cover your mouth with a mask or scarf.

  • Avoid exercising outside on days when there is a lot of pollen or air pollution.

  • Get in good physical shape gradually before trying vigorous types of exercise.

  • Always allow at least 10 minutes of warm-up time before exercise.

  • Gradually cool down at the end of your workout instead of stopping suddenly.

  • Wait at least two hours between bouts of exercising.

If you have EIB, the best types of exercise for you may be swimming, walking, or easy bicycling.

Living with EIB doesn’t mean you need to give up exercise. Exercise is important for a healthy lifestyle, and most people with EIB can enjoy exercise safely.