In addition to asking questions about your symptoms, your doctor will conduct a medical exam. He or she will also order tests to assess your lung function and rule out other conditions that may be causing your symptoms.
Test of normal lung function
Your doctor will likely administer a spirometry (spy-ROM-uh-tree) test to assess how well your lungs function when you aren't exercising. A spirometer measures how much air you inhale, how much you exhale and how quickly you exhale.
After you do the test, your doctor may give you an inhaled medication to open your lungs (bronchodilator). You'll repeat the test, and your doctor will compare the results of the two measurements to see whether the bronchodilator improved your airflow. This initial lung function test is important for ruling out underlying chronic asthma as the cause of symptoms.
Exercise challenge tests
An additional test that enables your doctor to observe and assess symptoms is an exercise challenge. You will run on a treadmill or use other stationary exercise equipment that increases your breathing rate. This exercise needs to be intense enough to trigger the symptoms you've experienced. If needed, you might be asked to perform a real-life exercise challenge, such as climbing stairs.
Spirometry tests before and after the challenge can provide evidence of exercise-induced bronchoconstriction.
Alternate challenge tests
As an alternative to the exercise challenge, your doctor may use an inhalation test that simulates the conditions that would likely trigger exercise-induced bronchoconstriction. If your airways respond to these stimuli, then the test should produce virtually the same lung function you have when exercising.
Again spirometry tests before and after the challenge test provide information about changes in lung function. These challenge tests include the following:
- Methacholine challenge, the use of an inhaled agent that interacts with certain smooth muscle cells in airways and results in bronchoconstriction
- Eucapnic voluntary hyperventilation (EVH) challenge, inhaling a mixture of dry air composed of oxygen, carbon dioxide and nitrogen that simulates the exchange of air when breathing is difficult
- Mannitol challenge, inhaling a dry powder that can trigger water loss on the surface of the airways and switch on molecular activity that controls inflammation — conditions that cause bronchoconstriction in people with oversensitive airways
Ruling out other conditions
Your doctor may order additional tests to rule out other conditions with symptoms similar to those of exercise-induced bronchoconstriction. These conditions include:
Oct. 25, 2014
- Vocal cord dysfunction
- Lung disease
- Irregular heartbeats (arrhythmia) or other heart conditions
- Gastroesophageal reflux disease
- Parsons JP. Exercise-induced bronchoconstriction. Otolaryngologic Clinics of North America. 2014;47:119.
- Parsons JP, et al. An official American Thoracic Society clinical practice guideline: Exercise-induced bronchoconstriction. American Journal of Respiratory and Critical Care Medicine. 2013;187:1016.
- Weiler JM, et al. Pathogenesis, prevalence, diagnosis and management of exercise-induced bronchoconstriction: A practice parameter. Annals of Allergy, Asthma & Immunology. 2010;105:S1.
- Krafczyk MA, et al. Exercise-induced bronchoconstriction: Diagnosis and management. American Family Physician. 2011;84:427.
- Randolph C. Pediatric exercise-induced bronchoconstriction: Contemporary developments in epidemiology, pathogenesis, presentation, diagnosis and therapy. Current Allergy and Asthma Reports. 2013;13:662.
- Anderson SD, et al. Assessment and prevention of exercise-induced bronchoconstriction. British Journal of Sports Medicine. 2012;46:391.
- Irvin CG. Broncoprovocation testing. http://www.uptodate.com/home. Accessed Sept. 12, 2014.
- Updated information on leukotriene inhibitors: Montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm165489.htm. Accessed Oct. 1, 2014.
- Stickland MK, et al. Effect of warm-up exercise on exercise-induced bronchoconstriction. Medicine and Science in Sports and Exercise. 2012;44:383.
- Asthma action plans: Help patients take control. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health-pro/resources/lung/naci/discover/action-plans.htm. Accessed Sept. 12, 2014.
- Mickleborough TD, et al. Exercise-induced asthma: Nutritional management. Current Sports Medicine Reports. 2011;10:197.
- Li JTC (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 22, 2014.
You Are ... The Campaign for Mayo Clinic
Mayo Clinic is a not-for-profit organization. Make a difference today.