There is, of course, no reason why asthma and exercise-induced bronchoconstriction should not co-exist but the distinction is important because without successful treatment of underlying asthma, treatment of an exercise component will likely be unsuccessful. If baseline testing is normal, some form of exercise or pharmacologic stress will be required, either on the sideline or practice venue, or in the laboratory. Exercise testing
Treadmill or ergometer-based testing in lung function laboratories are effective methods for diagnosing exercise-induced bronchoconstriction, but may result in false negatives if the exercise stimulus is not intense enough. Field-exercise challenge
Field-exercise challenge tests that involve the athlete performing the sport in which they are normally involved and assessing FEV1 after exercise are helpful if abnormal but have been shown to be less sensitive than eucapnic voluntary hyperventilation. Eucapnic voluntary hyperventilation challenge
The International Olympic Committee recommends the eucapnic voluntary hyperventilation (EVH) challenge as the test to document exercise-induced asthma  in Olympic athletes. In the EVH challenge, the patient voluntarily, without exercising, rapidly breathes dry air enriched with 5% CO2 for six minutes. The presence of the enriched CO2 compensates for the CO2 losses in the expired air, not matched by metabolic production, that occurs during hyperventilation, and so maintains CO2 levels at normal. Medication challenge
Medication challenge tests, such as the methacholine challenge test, have a lower sensitivity for detection of exercise-induced bronchoconstriction in athletes and are also not a recommended first-line approach in the evaluation of exercise-induced asthma.Mannitol inhalation has been recently approved for use in the United States.
Research
A crossover study compared oral montelukast with inhaled salmeterol, both given two hours before exercise, showing that the drugs had similar benefit.A meta-analysis of preliminary research indicated that vitamin C may be useful to relieve respiratory symptoms such as cough during exercise. Prognosis
As evidenced by many professional athletes who have overcome EIB using some combination of accepted treatments, the prognosis is usually very good. Olympic swimmers Tom Dolan, Amy Van Dyken, and Nancy Hogshead, Olympic track star Jackie Joyner-Kersee, baseball Hall of Famer Catfish Hunter, and American football player Jerome Bettis are among the many who have done so. Tour de France winner Chris Froome reported that he suffers from the condition, after being spotted using a nasal inhaler during race. Other athletes with EIB include racing cyclist Simon Yates, distance runner Paula Radcliffe and cross-country skier Marit Bjørgen. Research by sports scientist John Dickinson found that 70 percent of UK-based members of the British swimming team had some form of asthma, as did a third of Team Sky cyclists, compared to a national asthma rate of eight to ten percent, whilst a study by the United States Olympic Committee in 2000 found that half of cross-country skiers had EIB. References
External links
"Tips to Remember: Exercise-induced asthma". American Academy of Allergy, Asthma, and Immunology. Retrieved 2007-04-12. Fact sheet: Exercise-induced asthma