American Medical Society for Sports Medicine
For Immediate Release Dec 28, 2004

Many young athletes are diagnosed with exercise-induced asthma (EIA) each year. Some of these people fail to respond to standard treatment, leading to frustration, not to mention decreased exercise performance. When this is the case, the athlete may be suffering from one of many “asthma masqueraders”, according to James L. Moeller, MD.

Dr. Moeller presented information regarding several of these asthma masqueraders at the Advanced Team Physician Course last week in Miami Beach , Florida . Among these masquerading problems are vocal cord dysfunction (VCD), gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR).

VCD takes place when the vocal cords close during inspiration, instead of opening as they should. This leads to inspiratory stridor and a feeling of shortness of breath. Many of the triggers for VCD are the same as for EIA, leading to more confusion between the two entities. Unlike EIA which usually causes expiratory wheezing after intense, moderate duration (6-10 minutes) exercise and can continue after completing exercise, VCD usually causes inspiratory stridor very early in the exercise session and it resolves very quickly once exercise is completed.

GERD and LPR are masqueraders that cause respiratory complaints due to the presence of stomach acid in the esophagus or voice box area. These conditions do not respond to, and may be worsened by, asthma medications. Lifestyle changes to prevent reflux and anti-reflux medications will lead to a decrease in respiratory complaints.

Remember, “all that wheezes is not asthma.” Be certain of your EIA diagnosis before starting an athlete on asthma medications. This requires thorough history, physical examination and pulmonary function testing under appropriate conditions. If an athlete’s EIA is not responding to their asthma treatments, consider a masquerader. Dr. Moeller is a sports medicine physician and member of the American Medical Society for Sports Medicine (AMSSM).

The American Medical Society for Sports Medicine (AMSSM) was organized in 1991by physicians who recognized the need for an organization within the field of sports medicine that approached athletes, exercising individuals, and teams comprehensively with consultative and continuous care of their orthopedic, medical, nutritional, and psychosocial issues. Although sports medicine concepts are often thought of in conjunction with professional and elite athletes, these concepts apply to athletes of all levels including grade school, high school, college and recreational athletes. AMSSM is comprised of over 800 Sports Medicine Physicians whose goal is to provide a link between the rapidly expanding core of knowledge related to sports medicine and its application to patients in a clinical setting.

NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415 or [email protected] .