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Exercise Induced Asthma
Question of the Week

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Q. My 9 year old son has seasonal allergies. He is on Allegra and Flonase. Over the past month he has had 2 episodes of coughing and wheezing that last about 30 minutes and then he is fine. One of them was during Karate class. The next one was while eating dinner. It started about 10 minutes into dinner. He had just come in from playing outside. He did not have a cold either time. He is prone to chest colds that last 2-3 weeks.

My question is whether he needs to be seen to access if he has asthma or not. Should I wait and see if he has any more attacks? He is a VERY active boy. Lois, Florida

A. He has fairly classic symptoms of exercise induced asthma, so an evaluation would likely be a very good idea and you don't really need to wait for more attacks, especially since they may be worse next time.

Kids with exercise induced asthma usually have trouble breathing about 5-20 minutes after they begin exercising, so that would explain each episode. Typical symptoms include coughing, wheezing, shortness of breath, and chest tightness. Some children aren't diagnosed until it is noticed that they aren't keeping up with other kids, even after you would expect them to get over any problems of being 'out of shape' or having 'poor conditioning.'

If after an evaluation your doctor does think that he has exercise induced asthma, he will likely prescribe a short-acting inhaler, like Proventil, Ventolin, albuterol, or Maxair, that your son would use about 10-15 minutes before he began exercising or playing sports. A long acting inhaler, like Serevent or Foradil, is also sometimes used so that your child doesn't have to use an inhaler at school.

A slow warm up before he begins any physical activity and stopping the activity if he begins to cough, wheeze, or have trouble breathing would also be a good idea. Frequent, brief rest periods and a warm-down period is also a good idea.

Fortunately, with proper treatment, it shouldn't really limit his activities. If it seems like it is, then you should see a Pediatric Pulmonologist for further evaluation and treatment.

Other possibilities for his 'attacks' is that it was just the pollens or molds in the air that trigger his seasonal allergies triggering a brief asthma attack, or that he had some other type of reaction, like a food allergy.

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