ASK THE DOCTOR; Handling Exercise-Induced Asthma

Dr. Jim Mitterando

Q. I worry that my son may have exercise-induced asthma. He seems to get quite short of breath when he plays soccer. He’s never had asthma or problems with sports. What do you recommend?

A. Exercise-induced asthma is common, affecting one in 14 people. Symptoms include shortness of breath, wheezing, chest tightness and cough associated only with exercise. You can have exercise-induced asthma without a prior asthma history. People with asthma have these symptoms at rest, as well. Many asthmatics also have exercise- induced asthma. Symptoms develop early in exercise and improve after 10 or 15 minutes as adrenaline kicks in to open constricted airways. Cold or dry air tends to cause more symptoms. Diagnosis can be made by history and examination of the heart and lungs. Your son should be evaluated by his doctor to ensure there are no other lung or heart issues impeding his sports participation. The most common test and treatment is simply to give the athlete an albuterol inhaler (Proventil, Ventolin) 15 minutes before exercise and see if this improves symptoms. Additional testing can be done in the doctor’s office with a pulmonary function test before and after exercise. Occasionally, other asthma medications are prescribed that require daily administration, such as a steroid inhaler (Flovent, Vanceril, Pulmicort) or a pill called Singulair. People with seasonal allergies or eczema are more likely to have asthma. Nighttime wheezing or coughing may suggest asthma. Asthma can worsen during a particular season or with an upper respiratory infection. In the past, exercise-induced asthma hindered kids’ ability to participate in sports. By using an albuterol inhaler before his sport, your son should feel more comfortable and maximize his performance. Dr. Jim Mitterando is a family doctor at Cohasset Family Practice and a staff member at South Shore Hospital in Weymouth.