Anstrengelsesutløst astma hos barn og ungdom : En oversiktsartikkel

Abstract

This review concerns the challenge of growing prevalence of exercise-induced asthma (EIA) in physically active children and adolescents. The article will encompass both mechanisms for developing exercise-induced asthma and bronchoconstriction in children and young athletes and how to manage these symptoms, as well as the epidemiology, diagnosis and treatment. EIA occurs in up to 70-80% percent of asthmatics and 8,6% of Norwegian 10-year-olds in the general population. The severity of the disease is thought to correspond to the exercise load and the level of ventilation during exercise, which in turn will cause increased heat and water loss through ventilation and add on to bronchial constriction. The daily increased ventilation rate in athletes is thought to lead in to increased epithelial damage of the airways and thus increased airway mucosal inflammation. Sports activity in areas with cold/dry air, chlorine compounds in swimming facilities or high particulate matter in ice-rinks, will all lead to higher incidence of bronchoconstriction and increase the asthmatic symptoms, because of the environmental exposure. Symptoms include coughing, wheezing, chest tightness and shortness of breath, during and in the end of an exercise or few minutes after. The diagnosis is confirmed with positive standardized exercise tests. Thus, asthma management and control is important for children and adolescents to be able to participate in daily physical activities, to increase cardiovascular fitness and to enjoy the benefits of an active lifestyle. This has been shown to improve quality of life and personal wellbeing. Both nonpharmacologic therapy and pharmacologic therapy in combination is essential to achieve the goal of getting all children with EIA to participate on the same level in physical activities as others, as well as taking environmental exposures to consideration. The asthmatic youth should follow the same guidelines for medical treatment as ordinary asthmatic patients.