The challenge of asthma in adolescent athletes: exercise induced bronchoconstriction (EIB) with and without known asthma.

Exercise induced bronchconstriction (EIB) is defined as a transient increase in airway resistance reflected as at least a 10% decline in FEV1 following at least 6-8 minutes of strenuous exercise. Up to 90% of asthmatics, 45% of individuals with allergic rhinitis, 50% of Olympic athletes, and 12% of the general population have EIB. EIB in adolescence may be either under- or over-diagnosed because of denial of symptoms or misperception of dyspnea or other respiratory symptoms. Diagnosis cannot always rely on history alone and may require an objective exercise challenge or surrogate measure. Management of EIB may require reduction in the exercise provoking the asthma but it can usually be successfully managed with training and the appropriate use of medications, including inhaled beta-agonists, inhaled steroids, and/or leukotriene antagonists. Nonpharmacologic therapy with face masks, warming up and down, and calisthenics may also be an effective adjunct in reducing medication needs. For most adolescents, proper pharmacotherapy will provide complete control of the airway and a normal healthy lifestyle without exercise restrictions.