Seeking relief from ‘exercise asthma’

Press, 23 June 1986, Page 11

Seeking relief from ‘exercise asthma’

From

Dr George Hanbury

for the Royal New Zealand College of General Practitioners

Family Doctor

We all get breathless with exertion, but some people, especially children, develop wheezing from spasm of their airways. It is called exerciseinduced asthma.

Typically, symptoms come on six to ten minutes after exercise starts, and Include chest tightness, shortness of breath, wheezing, cough and sometimes stomach ache. A second phase, usually more severe, comes on after the exercise has finished. The symptoms last half to one hour.

Many have theorised as to why. Cold air, cooling the airways, seems to be a main factor.

Spasm of the airways can be brought on by overbreathing cold, dry air, even without the' exercise, and activities usually performed in a cold, dry environment (winter running, crosscountry skl-ing) are more likely to cause these symptoms in the susceptible than Indoor sports.

Avoiding the stimulus constitutes the first line of attack. Change to Indoor sports if outdoor ones cause the problem.

If keen to continue the activities that cause the wheezing, breathing through a scarf or mask may be helpful, but medications can be very effective. Inhaled aerosol medicines designed to widen the narrowed airways before they become narrowed are often successful in preventing the problem.

Susceptible adults should take two or three puffs of a prescribed in-

haler 15 minutes before exercise (correspondingly less for a child). Another type of medication is disodium cromogly-, cate, which stabilises some of the cells that release body chemicals .that cause spasm; it is a useful second line strategy. If each fails, a combination of both is usually effective. Next, the person should warm up with moderate exercise such as light running and stretching, calisthenics for two or three minutes. After this he or she can begin to exercise fully. If wheezing develops, some people can "run through” their symptoms, but if this cannot be done, exercise should stop, and" the sufferer should re-use the inhaler. For some, exercise-in-duced asthma cannot be controlled outdoors, and the only answer will be swimming or Indoor running.

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