Royal Brompton doctor gives advice on exercise–induced breathing problems

EILO imageA Royal Brompton consultant has advised patients complaining of exercise-induced breathlessness to take selfies when exercising.

Consultant respiratory physician, Dr James Hull, gave the unusual advice at the first international conference on EILO (exercise-induced laryngeal obstruction), which was held this week in London.

Respiratory experts believe this tactic may improve diagnosis of EILO, a condition that causes breathlessness and is often mistaken for asthma by GPs. In fact, the problem is with the voice box, not the lungs.

One way of helping doctors differentiate between EILO and exercise-induced asthma is to set up a selfie video when running on a treadmill, to show how exercise impacts breathing.

Dr Hull commented:  “The wheeze with EILO typically occurs when people are exercising, while asthma wheezing typically occurs when they finish.”

“We believe what happens with EILO is that the air flow goes over the back of the voice box area. It pulls the voice box together. This means people feel they can’t get a breath in.

“They get a wheezing sound when they’re breathing in, and they can often cough with it. When they go and see a GP they are given asthma treatment, which is never going to work. We need to get the message out so people don’t get told this is asthma.”

The condition often goes under the radar, and Dr Hull believes it may affect up to 10 per cent of people under 25.

The good news is, symptoms can be eased by breathing exercises. Another option is surgically removing the excess tissue around the larynx which removes the troubling symptoms.

As many as 400 patients with the conditions have been treated by Dr Hull at his Royal Brompton clinic.

One patient, 30 year-old theatre technician Niki Ingle, from Cheshunt, Hertfordshire explained how the condition had impacted her life.

She said: “I wasn’t able to walk and talk at the same time. I’d been given an asthma pump, but it did nothing.  I would be out of breath. I couldn’t run for a bus. I hated carrying shopping up the stairs.”

Two years ago, Niki was referred to Royal Brompton and diagnosed with EILO.

Ear, nose and throat surgeon Mr Guri Sandhu from neighbouring Chelsea and Westminster Hospital removed the excess tissue, and Niki says the treatment has been life-changing:

“I go to the gym three or four times a week. I jog. I have got the life I never had. It affected relationships and my personality. I thought I wouldn’t be able to have children as I would never be able to keep up with them. Now it’s a possibility.”

Niki said of her treatment by staff at Royal Brompton: “I can’t sing their praises enough.”

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