Many people with asthma know that exercising with air conditioning can be a very trying experience. Even the most motivated athletes may develop breathing problems with only moderate activity if they are not well prepared. Below, two experts discuss exercise-induced asthma, and how it can be treated.

What is exercise-induced asthma?

ADAM HUREWITZ, MD: Asthma can be anything from a very mild disease that causes occasional problems to a life-threatening disease that puts patients' well-being in jeopardy. Those who suffer with exercise-induced asthma suffer their symptoms primarily during exercise, and sometimes have no other asthmatic symptoms. When they exercise, most often in cold weather, they begin to wheeze, become short of breath, and have all the characteristics of asthma, but often only during exercise. They may have no symptoms when they are not exercising.

Now that doesn't mean that other asthmatics won't also have exercise-induced symptoms as well, but these individuals we're referring to may have it only during that period of exercise, and most often during cold weather.

We have some famous athletes who suffer from exercise-induced asthma like Jackie Joyner Kersey.

ADAM HUREWITZ, MD: She is one of the more famous. Bobby Clark, who used to play for the Philadelphia Flyers, had a component of asthma as well. It's not uncommon that there are famous athletes and famous people in all walks of life who have asthma. Certainly for the athlete, it may have a significant impact on their capacity to perform.

Are there exercises that are more likely to induce an attack than others?

ADAM HUREWITZ, MD: Cold air is a primary problem for people who suffer with exercise-induced asthma. So cold weather sports are a danger. Anything in the cold air is far more likely to induce an asthma attack than in warm weather. There are, however, both children and adults who can suffer with exercise-induced asthma even in warm weather.

All the other irritants that we are concerned about with asthma can also be more likely to induce the problem during exercise. So we would be concerned about allergens during the springtime when somebody is out running, simply because they enjoy running, but they get exposed to pollens and tree dusts and things that we know trigger asthma anyway. That may increase the likelihood of having exercise-induced asthma.

What's the best treatment approach for exercise-induced asthma?

JONATHAN ILOWITE, MD: In the long run, exercise has been shown to be good for asthma, but in the short-run, people who suffer with exercise-induced asthma need to know how to avoid the severe attacks that exercise can precipitate.

If they take a reliever medication before they exercise, frequently an attack will be completely or at least partially alleviated.

But reliever medications are short-acting. So if the duration of exercise is going to be greater than a few hours, then the reliever medication is going to wear off, and then they may develop an asthma attack during the period of time when the reliever medication wears off. In that case, we have to try other approaches.

So the take-home message is, you don't need to stop exercising just because you have asthma?

ADAM HUREWITZ, MD: I think that that's important. In this day and age, we would like to restore asthmatics to perfectly normal active lives. We encourage activity. Years ago, there was often an effort to discourage the asthmatic from participating in sports because they developed symptoms. There is not only no longer a reason to do that. With today's medications, they can participate fully.

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