Asthma Complexities (cont.)
Ways to prevent and treat exercise-induced asthma
- Choose an appropriate sport.
- Make sure that your asthma is under good control
before you begin exercising. Refrain from exercise and consult your doctor if
your asthma is poorly controlled.
- Warm up for at least 10 minutes prior to exercise.
This takes advantage of a "window of safety" which may last up to an hour,
often preventing exercise-induced asthma.
- Avoid exercising in cold, dry air and on smoggy days.
Covering the mouth and nose with a scarf in cold weather can be helpful.
- If asthma symptoms occur during exercise, stop
immediately and rest. Do not attempt to "run through" the symptoms. If your
breathing difficulty continues, use an inhaled bronchodilator.
- Following completion of exercise, do "cool down"
exercises for 10 minutes to allow the bronchial tubes to re-warm slowly.
- Preventative use of inhalers that contain cromolyn
sodium (Intal) or
bronchodilators, such as albuterol (Ventolin, Proventil), 15 to 20 minutes
before exercise is usually effective. Long-acting bronchodilators, such as
salmeterol (Serevent), should be taken 60 minutes before exercise. Recently,
the leukotriene modifiers, montelukast (Singulair) and zafirlukast
(Accolate), taken daily in pill form have been found to help prevent
exercise-induced asthma in some athletes.
Conditions that may worsen asthma
Gastroesophageal reflux disease (GERD)
GERD is a common condition caused by the regurgitation (reflux) or backwash
of stomach acid into the esophagus from the stomach. At times, the acid even may
regurgitate into the back of the throat and reach the lungs. GERD usually -- but
not always -- is associated with a burning discomfort under the breastbone, called
heartburn, which occurs mostly after meals or when lying down. In some patients,
the symptom of acid reflux is not heartburn. Instead, they experience coughing,
wheezing, hoarseness, or sore throat.
The presence of acid in the esophagus or the passage of acid into the lungs
(aspiration) may cause the bronchial tubes to constrict (bronchospasm), causing
wheezing and coughing that may not respond to medications for asthma.
Bronchospasm related to acid reflux tends to occur more frequently at night as a
result of lying down. Interestingly, GERD is common among patients with asthma.
Some doctors believe that asthma itself or asthma treatments in some way make
asthma patients more susceptible to acid reflux. For example, theophylline, an oral
medication occasionally used to treat asthma, may promote acid reflux by
relaxing the specialized muscles in the esophagus that normally tighten to
prevent regurgitation of acid.
In patients with nocturnal or difficult-to-control
asthma, treating acid reflux may help relieve coughing and wheezing. Treatment
of GERD involves elevating the head of the bed, losing weight, avoiding spicy
food, caffeine, alcohol, and cigarettes. Proton-pump inhibitors such as omeprazole (Prilosec), pantoprazole (Protonix),
rabeprazole (Aciphex), lansoprazole (Prevacid), and esomeprazole (Nexium) are potent inhibitors of production of acid in the
stomach and are effective treatments for asthma aggravated or caused by acid
reflux. Rarely, surgery is performed to prevent acid reflux for severe cases of
GERD that do not respond to medications.
Next: The allergic rhinitis-asthma connection »
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