[Exercise-induced bronchospasm and its prevention]

Exercise-induced bronchospasm (EIB) is a type of nonspecific bronchial hyperreactivity. It affects mostly children and younger adults with asthma (75%-95%) and allergic rhinitis (40%), but it is also found in 3-11% of the nonasthmatic and nonatopic younger population. Pathophysiology of this phenomenon is not clear and there are some attempts to explain it with hyperosmolality of bronchial epithelia, exchange of heat and water (reactive hyperemia) in airways and reflex vagal bronchospasm. Unrecognized and uncontrolled symptoms of EIB can lead patients to avoid general and occupational physical activities and sports. Diagnosis of EIB is focused on medical history and on pulmonary function testing after standardized exercise testing protocols on treadmill, cycle ergometer or by free running. Non-pharmacological and pharmacological prophylactic measures are the most important approach in the therapy of EIB. Inhalation of beta 2-agonists or cromolyns is the first choice in pharmacological prevention of EIB. With adequate therapy, symptoms of EIB can be controlled enough to maintain everyday as well as sports activities.