Do you get chest tightness even when you exercise? Let's talk about (Exercise-Induced Asthma)!

Do you sometimes suddenly find it hard to breathe when you exercise, run, or play sports? Do you feel like your chest is tight, you feel like you're coughing, or maybe you have a wheezing sound coming from your chest? If so, you may have the condition we're talking about today. This is something that many people experience, so don't panic. Let's talk about this in detail.

What is exercise-induced asthma?

Simply put, when you exercise, that is, when you exert yourself, the airways in your chest (also called airways) become temporarily narrowed, which is what we call ``Exercise-Induced Asthma''. Some people also call it ``Exercise-Induced Bronchoconstriction'' or ``EIB'' . What happens is that when you exert yourself, your airways become narrower. That's when you have difficulty breathing, you cough, your chest feels tight, and sometimes you can make a wheezing sound (also called ``wheezing'' in medical terms). There are times when these symptoms can be particularly severe . Think about it,

• If the surrounding air is very cold and dry .
• If the amount of pollen in the environment is high .
• If air pollution is high .

At times like this, the situation is likely to get worse.

How common is this situation?

It's more common than you might think. Between 40% and 90% of people with asthma experience these symptoms during or after exercise. But surprisingly, it can also happen to people without asthma. About 20% of the general population (including both asthmatics and non-asthmatics) experience these symptoms during exercise. So it's not just you, many other people have this problem.

What are the symptoms of this?

Let's see what symptoms appear in this ``Exercise-Induced Asthma'' condition.

• A feeling of tightness or tightness in the chest , as if someone is squeezing the chest.
• Cough . For some people, a cough may be the only symptom. If you experience a persistent cough, whether during or after exercise, you should be concerned.
• Difficulty breathing (we also call this `shortness of breath`). It may feel like it is hard to breathe out.

These symptoms can be mild for some people, and more severe for others. They can start within minutes of you starting to exercise, or they can happen after you've finished exercising. But the good news is that they usually subside after about 30 minutes of rest.These symptoms gradually subside. However, sometimes, these symptoms can reappear several hours after you finish exercising, up to 12 hours later . They can also occur when you are just standing still. We call this " late-phase symptoms ." It can take up to a day for these late-phase symptoms to completely disappear.

What causes this?

Intense, continuous aerobic exercise is the main cause of this condition, called Exercise-Induced Asthma. This condition can be made worse by:

• If the surrounding air is cold and dry .
• If the amount of pollen in the environment is high.
• If the air quality is poor due to air pollution .
• If you are recovering from a respiratory infection such as a cold , cough, or flu .
• If you breathe in things like smoke, chemicals , paint, or fumes from cleaning products .

Imagine a person going for a run in the morning on a cold day. They are breathing in cold, dry air. When this air enters the lungs, the airways become even more constricted, meaning they become blocked. That's when these problems arise.

What kind of activities does this cause the most?

Although any physical activity can cause these symptoms, it is most commonly caused by strenuous physical activity without frequent rest and sports played in cold weather . Here are a few examples:

• Basketball
• Ice hockey
• Ice skating
• Long distance running
• Skiing, Snowboarding
• Football

Also, swimming in an indoor, chlorinated pool , diving, or playing water polo can be harmful to your lungs and aggravate this condition.

Who is most at risk for this?

People with asthma and allergies are more likely to develop exercise-induced bronchoconstriction. It is also common in high-performance athletes , such as Olympic athletes and professional football and hockey players. Studies have shown that between 30% and 70% of these high-level athletes haveIt is possible to have `(Exercise-Induced Asthma)`.

How do you recognize this?

When you go to a doctor, he or she will ask you about your symptoms. That is, how long you have had them, how long they have been present, and what time of day they are most common. He or she will also ask if anyone in your family has asthma or other respiratory problems. Then the doctor or nurse will place a stethoscope on your chest and listen to your breathing and heart rate. In addition, they may do a few other tests. These include:

• Pulmonary function tests : These check how well your lungs are working. One of the most common pulmonary function tests used to diagnose asthma is a spirometry test . This involves you blowing air into a small device that measures things like your lung capacity and breathing rate.
• Exercise challenge test : This is also called a bronchoprovocation test . In this test, you are asked to run on a treadmill or ride a stationary bike. Then, you are given a spirometry test before and after the exercise to see if there is any change in your breathing.
• Chest X-ray : Your doctor may order a chest X-ray to check for other causes of your symptoms.

How is this treated?

Treatment for exercise-induced asthma focuses on preventing symptoms and relieving them when they occur . In addition to preventative measures, such as warming up before exercise, your doctor may prescribe medications to help. Some medications open up your airways when you have symptoms, while others prevent symptoms from occurring.

Medications for exercise-induced asthma

Your doctor may prescribe you medication that you breathe in through an inhaler or a nebulizer . These can help prevent symptoms and relieve them if they occur. Here are some types of inhaled medications for exercise-induced asthma:

• Short-acting beta-agonists (SABAs) : These belong to a class of drugs called bronchodilators. They work by relaxing the muscles in your airways and opening your airways. They are also called "rescue inhalers." They can be used to relieve symptoms during an "EIB" episode. They can also be used to prevent asthma symptoms from occurring if taken about 15 minutes before exercise.
• Long-acting beta-agonists (LABAs) : This is another type of bronchodilator. They are usually given in combination with corticosteroids (they are not used alone for asthma). If you inhale these medications 30 minutes to an hour before exercising, they can help prevent EIB.
• Corticosteroids : These work by reducing swelling in your airways and making it easier for your air to pass through. Your doctor may prescribe these to take daily to help prevent symptoms.
• Mast cell stabilizers : These work by reducing inflammation in your airways. Inhaling this medication through a nebulizer about 15 minutes before exercise can help prevent symptoms.

In addition, medications called leukotriene modifiers and antihistamines can help reduce asthma symptoms in some people.

What kind of life can I expect with this situation?

Many people manage their asthma well with exercise or sports-induced asthma and lead active, healthy lives . You too can, with proper planning, treatment, and exercise and engage in the various sports and activities you enjoy. So don't worry too much about it.

Can this be prevented?

Yes, you can greatly reduce your risk of developing asthma by planning and preparing. Before engaging in any physical activity, you should:

• Allow time for a warm-up : Before starting any exercise, warm up for 6 to 10 minutes . This warm-up may vary depending on your age, health, and the sport you are playing. Ask your doctor what kind of warm-up is right for you.
• Check pollen and air quality : Before you go for an outdoor workout, check the air quality index. If pollution and pollen levels are high, it's best to exercise indoors.
• Cover your mouth and nose : Use a face mask, scarf, or similar item to protect your respiratory tract from cold, dry air.
• Control asthma symptoms : If you have asthma, talk to your doctor before starting an exercise program to control your symptoms. Follow your doctor's instructions when using your inhaler and taking your asthma medications.
• Tell coaches and teachers : If your child has asthma, make teachers and coaches aware of it. Adults need to know what the symptoms are, what to do if they occur, and how to help administer medication.
• Be aware of symptoms.: Always be on the lookout for your (or your child's) asthma symptoms that are triggered by exercise. Have a plan for what to do if you notice signs of an ``EIB''. Remember, symptoms can come on minutes (or even hours) after you've finished exercising.

Important: Choose indoor sports or low-intensity sports if you can. If sports trigger your asthma, it's best to choose some activities over others. Endurance sports and activities in cold environments can make your symptoms worse. If you enjoy water sports, it may help to do them in a non-chlorinated saltwater pool or natural reservoir.

What types of games are less likely to cause this condition?

Indoor sports and activities that are low-intensity, or involve short bursts of activity, are less likely to trigger asthma attacks. Here are some examples:

• Baseball
• Bowling
• Fencing
• Golf
• Gymnastics
• Pickleball
• Sprints
• Tennis
• Volleyball
• Walking

How do I know if I have this?

If you experience asthma symptoms (such as coughing and shortness of breath) during or shortly after exercise, you may have ``Exercise-Induced Asthma''. However, the symptoms can be similar to those of other conditions. So, be sure to see a doctor to get a proper diagnosis .

When should I see a doctor?

If you or your child has symptoms of `(EIB)`, talk to a doctor. If possible, take note of the following and tell the doctor :

• What are your symptoms?
• What do they come when you do? (Always doing the same activity? Indoors or outdoors?)
• How long has it been since the symptoms started?
• Does doing anything reduce the symptoms? If so, what is it?

If you are prescribed an inhaler, ask your doctor to show you how to use it properly . Don't be afraid to ask questions about how to use it properly.

When should I go to an emergency room (ER)?

If you or your child suddenly has severe difficulty breathing or is choking , seek medical attention immediately. Call 911 (or 1990 in Sri Lanka) or go directly to the emergency room. This should be treated as an emergency.

What questions should I ask the doctor?

When you see your doctor, it may be helpful to ask questions like these:

• What can I do to prevent symptoms?
• Can I continue to engage in the sports or activities I enjoy?
• How to use this medicine?
• Could you please show me again how to use the inhaler ?

Finally, remember this.

Whether you're a weekend exerciser or a professional athlete, asthma symptoms can disrupt your workday. However, many people with exercise-induced asthma can continue to play sports, participate in a variety of activities, and lead active lives. Taking a few extra steps, like warming up, can make a big difference. Talk to your doctor about medications that can help you breathe easier. With lifestyle changes and planning ahead, you can stay active and exercise safely. Don't worry, this is a manageable condition! Exercise-Induced Asthma, EIB, Breathing Difficulty, Asthma Symptoms, Inhalers, Respiratory Disease, Sports Asthma