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Exercise-induced bronchoconstriction: diagnosis and management.
Michael A Krafczyk1, Chad A Asplund
1St. Luke's Hospital and Health Network Primary Care Sport Medicine Fellowship Program, Bethlehem, PA 18017, USA. mkrafczyk@gmail.com
American Family Physician
|August 17, 2011
Summary
Exercise-induced bronchoconstriction (EIB) affects many, including athletes, causing airway narrowing during exercise. Diagnosis involves spirometry and may require further testing, with various treatment options available.
Area of Science:
- Pulmonology
- Sports Medicine
- Exercise Physiology
Background:
- Exercise-induced bronchoconstriction (EIB) is airway narrowing during physical activity.
- Affects over 10% of the general population and up to 90% of individuals with asthma.
- Symptoms range from classic wheezing to nonspecific fatigue and performance decline in athletes.
Purpose of the Study:
- To outline the diagnosis and management of exercise-induced bronchoconstriction.
- To differentiate EIB from other potential causes of exercise-related symptoms.
Main Methods:
- Initial evaluation with spirometry to assess for underlying asthma.
- Consideration of empiric short-acting beta₂ agonists trial or bronchial provocation testing for diagnosis.
- Review of nonpharmacologic and pharmacologic treatment strategies.
Main Results:
- Spirometry results for EIB can be normal.
- Nonpharmacologic strategies include trigger avoidance and environmental modifications.
- First-line pharmacologic treatment involves short-acting beta₂ agonists; other agents may be used for refractory cases.
Conclusions:
- Accurate diagnosis of EIB is crucial, sometimes requiring advanced testing.
- A multi-faceted approach combining nonpharmacologic and pharmacologic treatments is effective.
- Persistent symptoms warrant consideration of alternative diagnoses beyond EIB.
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