Challenges in the Management of Exercise-induced Asthma

William Storms, MD


Expert Rev Clin Immunol. 2009;5(3) 

In This Article

Abstract and Introduction


Exercise and physical activity are common triggers of symptoms in patients with asthma, although some individuals – especially athletes – may have symptoms with exercise alone. Exercise-induced bronchospasm (EIB) describes airway hyper-reactivity that is observed following exercise in a patient who is not otherwise diagnosed with asthma; exercise-induced asthma (EIA) describes airway hyper-reactivity associated with exercise in a patient who has persistent asthma. Specific challenges affecting both the diagnosis and treatment of these conditions are discussed in this review. The past decade has seen substantial advances in our understanding of EIA and EIB, including new guidelines on their management. With appropriate therapy, all patients with exercise-related symptoms should be able to reach their desired level of performance.


Exercise and physical activity are common triggers of symptoms in patients with asthma, and the term exercise-induced asthma (EIA) has been used for almost 50 years to describe the characteristic bronchial hyper-reactivity (BHR) observed in response to exercise or physical activity.[1] EIA is not a unique form of asthma, nor is it a subtype or phenotype of the disease and, while more than 90% of asthma patients develop respiratory symptoms following an appropriate exercise challenge, others respond to normal activities of daily life with symptoms requiring treatment.[1,2]


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