I have heard many stories from patients about what they have been told about their asthma. Many times the information they have received, or at least remember, is false. One of the more common stories I have heard is from patients who say they only have their asthma symptoms (primarily wheezing) when they exercise. Many times they even fail to tell me this symptom until asked.
Wheezing with activity, or exercise induced bronchospasm (EIB), is caused primarily by airway dehydration. This symptom may occur in athletes that exercise at a high level of activity, such as Olympic athletes. For most of us, this is part of the symptom complex that makes up asthma. Said in a different way, if you have EIB you have asthma, and your disease is not limited just to times when you have activity. Periods of activity may be when you notice your symptoms the most, but you are at risk for symptoms at other times as well.
Diagnosing someone with EIB uses the same approach that we use for asthma in general. A provocative test called a provocholine challenge test, which tests for the presence of reactive airway or bronchospasm, will almost always tell us if patients with exercise symptoms have underlying asthma. This test is easy to tolerate and involves breathing in several doses of a drug called provocholine and then blowing into the pulmonary function machine several times. If the one second airflow drops by 20% or more the diagnosis is confirmed.