25 April 2012

Athletes With Asthma May Be Using Wrong Medication Due To Misdiagnosis


Asthma is a breathing disorder that causes air passages of the lungs to swell and narrow. These air passages are called bronchioles. During an asthma attack, the muscles surrounding the airways become tight and the lining of the air passages swells. This reduces the amount of air that can pass by.

Bronchioles are the first airways by which air passes through the nose or mouth to the air sacs of the lungs. With asthma, these bronchioles swell and become narrow which results in wheezing, shortness of breath, tightening of the chest, and coughing.

Asthma can be caused by chemicals in the air or food, exercise, weather, stress, medicine, and allergens. These are called triggers.

There is no cure for asthma but the disorder can be managed and controlled. Inhaled corticosteroids help keep the airways from swelling which help prevent asthma symptoms. There are also long-acting beta-agonist inhalers which prevent the symptoms but these must be used together with another inhaled steroid drug.

Avoiding asthma triggers is also important in maintaining control and preventing attacks. Cigarette smoking and second hand smoke (passive smoke) in regard to people with asthma causes problems in effectiveness of management medications such as steroid/corticosteroid therapies.

Many athletes with asthma may be using the wrong treatment

Many athletes with asthma may not be using the best treatment for their condition and could be putting their long term health at risk, according to a roundup by journalist Sophie Arie published by the BMJ today.

The article will feature on the BMJ's new Olympics portal, an online resource to keep doctors up to date with sports medicine content from across the BMJ Group. The portal will be open until the end of the Olympic and Para-Olympic games.

Asthma is strikingly common in elite athletes and has gradually risen at almost every Olympics since the 1970s. In 2004 almost 21% of Team GB had asthma compared with 8% of the British population.

Video: What is Asthma


Marathon runner Paula Radcliffe is a well known athlete with asthma and it is thought that intense exertion over long periods can trigger symptoms.

A belief that inhaled asthma drugs (known as beta-2-agonists or IBAs) could enhance performance led to suspicions that some athletes might be declaring themselves asthmatic in order to take the drugs. But studies have found no evidence that inhaled asthma drugs improve performance. Tests introduced in 2001 revealed that some athletes had been misdiagnosed while others had asthma without realising it.

This has led to concerns that some athletes may be harming themselves by using the wrong medication. For example, many athletes may have exercise-induced asthma which needs to be managed and treated differently to full blown asthma.

However, a 2011 study showed that asthmatic athletes have consistently outperformed healthy athletes at every Olympic Games since 2000. So how do they manage to perform so well, despite their obvious handicap?

Most elite athletes with asthma have a detailed understanding of their condition and how best to control it while still training hard. Paula Radcliffe often talks about her asthma to encourage others to manage their asthma better.

And scientists now agree that exercise in most people with asthma enhances their lung function and improves their quality of life.

"The general message is that mild exercise should be recommended to asthmatics as part of their symptom management programme," says Dr Greg Whyte, former director of research for the British Olympic Association and professor of applied sport and exercise science at Liverpool John Moores University.

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