| Exercise induced asthma (EIA) affects about 40-90% of children with asthma, and occurs when a child's asthma is triggered by exercise or physical activities. Symptoms of coughing, wheezing, chest pain and difficulty breathing usually begin a few minutes after starting the activity and worsen over the next 5-10 minutes. Symptoms usually continue for about 20-30 minutes.
It can sometimes be helpful to check peak flows before and during exercise to see if they drop, as this can be a sign that your child has exercise induced asthma.
It can sometimes be difficult to diagnosis children with exercise induced asthma if exercise is their only trigger and they don't otherwise have symptoms of asthma, since they usually have normal exams and normal peak flows when they come to the doctor. Some of these children may be thought to just be 'out of shape' or have poor endurance. If there is any doubt, a trial of a bronchodilator before exercise may be helpful to see if there is any improvement.
With proper treatment, your child should not have any limitation in his activities. There are even people who participate in the Olympics who have asthma.
Treatments for exercise induced asthma include choosing activities that often don't trigger asthma, including walking, swimming, and bicycle riding. He can then work his way up to more strenuous activities, such as baseball and tennis, and finally soccer, basketball or hockey as his endurance increases. It may also be helpful to have a short period where he 'warms up' before he starts to participate in vigorous physical activities.
Exercise induced asthma can also be made worse by exercising in cold, dry air, or on days when there is a lot of pollution.
Most children with exercise induced asthma can be treated with a short acting bronchodilator (albuterol) about 5-30 minutes prior to physical activities that trigger their asthma symptoms. This can prevent asthma symptoms from developing for 2-3 hours.
An anti-inflammatory medication (Intal) also used 5-30 minutes prior to physical activity can prevent asthma symptoms from developing for 1-2 hours. A long acting bronchodilator (Serevent) may also be used if he is still having problems, and this can prevent asthma symptoms from developing for 10-12 hours.
Regular use of an inhaled steroid may also help prevent exercise induced symptoms if your child also has chronic asthma that is poorly controlled. Inhaled steroids will not work if used only before exercise though.
Leukotriene antagonists used regularly may also help decreased symptoms of exercise induced asthma.
Let your Pediatrician know if your child's asthma seems to be limiting his participation in sports or other physical activities or if he does not seem to be able to keep up with other kids his age.
Keep in mind that there may be times, especially after an asthma attack or when he , that he is not able to participate in exercises up to his full potential. He should slowly ease back into physical activities after an asthma exacerbation and be allowed to rest as needed. He may also need to avoid physical activities on days when it is very windy, cold or if it is a severe allergy day.
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