Modern Health Therapy

Severity of symptoms

The severity of symptoms depends on:

- Individual response (some individuals are much more sensitive than others.) This response may, in turn, vary according to circumstances (worse during colds or allergic crises).

- The dry, cold air, the drier and colder air, the greater the changes in the lining of the airways and the greater the stimulus for the release of chemical meters of inflammation, which produce bronchoconstriction and give greater lead to more serious symptoms.

- The continued exercise (eg running) causes more severe attacks that intermittent exercise (eg, tennis).

- The intensity of exercise is also important: the more intense, what are the symptoms: intense exercise demands a deep and rapid breathing, leading to dehydration and cooling of the lining of the airways.In summary, exercise-induced asthma may be displayed:

- In highly sensitive patients, even with minimal exercise

- In some sensitive patients who exercise very vigorously, as amateur or professional athletes

- In the intermediate cases, with an intermediate sensitivity and moderate exercise levels.

Can i do exercise if I suffer from exercise-induced asthma?

Definitely yes. There are many athletes who have exercise-induced asthma and there are many steps you can take to solve this problem:

Asthma medication: There are various asthma medication, usually an inhaler such as salbutamol (Ventolin), terbutaline (Terbasmin), salmeterol (Serevent), formoterol (Oxis), cromolyn sodium, nedocromil (Tilade), etc., Which used before exercise-induced asthma avoid exercise.

These medications such as salbutamol, terbutaline and cromolyn, are authorized by the committees and sports authorities, although this varies from country to country. Professional athletes should consult with your doctor if you take medication for asthma, because some preparations contain unauthorized substances such as ephedrine.

Kinds of exercise: patients with poorly controlled asthma should try a type of exercise you can tolerate. Swimming and bowling are particularly suitable. They should avoid exercise when your asthma is unstable.

Appropriate treatment: it is very important to have a proper and optimal treatment of asthma. It should avoid being under-treated, ie, with low doses of medication or inappropriate medication. Keep in mind that in some patients under-treated asthma attacks during exercise may be particularly dangerous in certain circumstances, like when there are high levels of air pollution, or very cold days.

How can I use medication to prevent exercise-induced asthma?

There are two ways:

- Short-term Protection

- Long-term protection.

Short-term protection

This protection lasts about 3 or 4 hours when the medication is taken before exercise. Usually, this type of inhaler medication should be used only in cases of mild intermittent asthma, which is not used anti-inflammatory medication (preventive) and is only used medication to relieve symptoms (bronchodilators), which also used less once a day. Drugs that can help to protect the short term, we have:

Inhalers: can help relieve the symptoms, which contain short-acting bronchodilators (usually blue), such as salbutamol or terbutaline, and prevent bronchoconstriction when released chemical mediators. Its onset of action is rapid (1 to 5 minutes) and its duration is short (4 to 6 hours at most).

Long-acting bronchodilators: instead of short-acting bronchodilators can be used long-acting bronchodilators (usually green), such as salmeterol or formoterol, which used every 12 hours provide coverage 24 hours a day. These can only be used bronchodilators alone (ie without preventive medication), in special circumstances, as the case of a child with mild asthma, in a sports activity day long and with limited access to short-acting bronchodilators.

Cromolyn sodium and nedocromil are used less often, but may be useful in amateur or professional athletes.

Long-term protection

Drugs “preventive” are very useful in asthma, reducing airway inflammation, which is the main mechanism by which asthma occurs. When used regularly, producing an overall improvement of asthmatic disease, which also includes exercise-induced attacks.

To be effective, these medicines must be used regularly and for long periods of time. They are not effective single dose taken before exercise and, usually, may need a week or more before they get benefits. The main drugs in this group are:

Inhaled corticosteroids, such as beclomethasone (Becloforte), fluticasone (Flixotide) and budesonide (Pulmicort). Inhaled corticosteroids are currently the main treatment of bronchial asthma because of its effectiveness and safety.

Receptor antagonists of leukotrienes, such as zafirlukast (Accolate) or montelukast (Singulair). They come in tablets and their effectiveness is difficult to predict, although proven to be effective in controlling exercise-induced asthma.

Other things you can do to reduce or prevent exercise-induced asthma:

- Avoid exercising outdoors on days when it’s cold or ice, as cold air is drier and cools and dries the lining of the airways, acting as a stimulus for the release of bronchoconstrictor activity of chemical mediators.

- Try to breathe through the nose because the nasal passages and humidify the air warmed, that this form is less irritating to airways.

- Before starting exercise, warm up with short courses of exercise, as this can reduce asthma that follows a period of more intense and prolonged exercise. The explanation for this phenomenon is unclear, but there are two factors that may play a role: 1) Short intervals of exercise can improve lung function. 2) Even if the warming does not cause asthma attacks, may reduce the ability of the airway cells to release chemical mediators that cause asthma symptoms.

- If exercise is poorly tolerated running, swimming should be tested, as the moist air environment causes less drying pools in the lining of the airways. You can also try an intermittent sport (eg tennis, bowling …) or work out in gyms or indoor (gym, aerobics, paddle, etc.).

- It is better to run short distances and speed exercise and sprint exercises in the background, because the speed workouts require only a few breaths, so there is less cooling and drying of the airways.

- Avoid exercise on days that there are a lot of pollen if you are allergic to pollens of grasses or other plants, or days you have a lot of pollution. With exercise, you breathe a lot of pollen / air pollution. These substances aggravate asthma, especially in patients more prone and unstable.

- The better the physical form need to breathe with less intensity, thus reducing the stimuli that can trigger asthma attacks.

- The most important thing is to keep the disease under control asthma. When asthma is well controlled, asthma attacks caused by exercise are greatly diminished (or even disappear).

Specific problems of exercise in patients with asthma

- The exercise-induced anaphylaxis. This is an extremely rare disease in which the combination of exercise and allergies to food has been eaten immediately before exercise, produce hypotension, collapse and respiratory distress (like serious allergic reactions to peanuts suffered by some patients).

- The exercise associated with laughter and excitement can trigger asthma attacks in some asthmatic children (birthday parties, visits from friends or relatives …). If this is likely, treatment should be anticipated by inhaled bronchodilators.

- Occasionally, patients with severe asthma suffer exercise-induced asthma despite optimal anti-asthma treatment. In these cases, it is recommended to make a type of exercise is best and least provocative of asthma.

credit to: Dr. Joaquin Muñiz Girón, Dr. Nicola Wilson

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