Exercise-induced bronchospasm-a review

The nature, causes and treatment of exercise-induced bronchospasm (E.I.B.) are reviewed. The condition is common, particularly in children. The spasm affects mainly the large airways; it appears a few minutes after effort, peaks in 10-15 minutes, and commonly resolves spontaneously in 40-60 minutes. The origin is probably multifactorial, with reflex stimulation of tracheal receptors, altered sympathetic neural discharge, prostaglandins and mast-cell sensitization being involved on different occasions. Effective treatments are equally varied, including selective beta agonists, theophylline and cromolyn glycate. For the sports physician, the best current approach seems the use of the Cromolyn drugs about one hour prior to competition.