Exercise-Induced Bronchoconstriction: The New Guidelines

Laura A. Stokowski, RN, MS; Jonathan P. Parsons, MD, MSc

Disclosures

February 03, 2014

In This Article

Editor's Note:
Exercise-induced bronchoconstriction (EIB) is an acute narrowing of the airway that occurs as a result of exercise. In winter, cold-weather sports, such as skiing and ice-skating, can provoke EIB in professional or recreational athletes.[1] To provide clinicians with practical guidance, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB and to develop evidence-based guidelines[2] for the diagnosis and treatment of EIB. Medscape had the opportunity to speak with the Chair of the panel, Jonathan P. Parsons, MD, MSc, about what primary care clinicians should know about EIB and the new guidelines for the next time a patient comes into the office complaining of chest tightness, coughing, wheezing, dyspnea, or other vague respiratory symptoms with exercise.

Medscape: Can we start with why you have changed the terminology from "exercise-induced asthma" to "exercise-induced bronchoconstriction"?

Jonathan P. Parsons, MD, MSc: We have gotten away from saying "exercise-induced asthma" for a couple of reasons. One is that a substantial percentage of patients don't have the phenotype of chronic asthma, but do experience EIB. So saying that they have some form of asthma is actually giving them an inaccurate label that we are trying to avoid putting on them. That is 10%-15% of the general population, and the only time that they have any kind of breathing issues is during exercise, which is really not consistent with chronic asthma. Chronic asthmatics can have symptoms at many other times -- when they are exposed to allergens, during upper respiratory infections, and so forth.

The other reason that we have gotten away from the term "exercise-induced asthma" it is that it implies that exercise causes asthma, and that is not true. Asthma is a complicated inflammatory disease of the airway, and exercise is one potential trigger that could cause symptoms of asthma to develop, but it doesn't really cause the disease itself. So those are the reasons why we have switched from "exercise-induced asthma" to EIB.

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