Understanding EILO on World ILO Day

Did you know that tomorrow, June 17th, is an international awareness day dedicated to educating the public about Inducible Laryngeal Obstruction (ILO)? It exists to raise awareness of ILO — the broader category of conditions (of which EILO is one) in which the larynx closes inappropriately in response to a trigger. For many athletes and active individuals, Exercise-Induced Laryngeal Obstruction (EILO) is one of the main conditions we treat at Functional Airway Lab.

What Is EILO?

EILO is a condition in which the larynx (voice box) narrows inappropriately during high-intensity exercise. Instead of remaining open to allow free airflow, the vocal cords and surrounding structures partially close or narrow, leaving a restricted airway and causing an onset of respiratory symptoms.

This narrowing is temporary and reversible, typically resolving within a few minutes of stopping exercise. EILO is not life-threatening, but it can be seriously disruptive to a person’s athletic participation, performance, and quality of life.

Common symptoms include:

• Shortness of breath — the most frequently reported symptom, occurring in nearly all patients
• Stridor — a harsh, noisy, high-pitched sound on inhalation
• Difficulty getting air in rather than out
• Throat tightness or discomfort
• Cough
• A sense of panic or anxiety during episodes

Symptoms are often worse during intense exercise and usually resolve quickly after activity stops — a key distinction from asthma, where symptoms can linger for much longer.

Who Gets EILO?

EILO is far more common than most people realize. It affects an estimated 5–7% of adolescents and young adults in general populations, with some studies suggesting it may be even more prevalent in highly trained athletes. One study found that among athletes referred for unexplained respiratory symptoms, over 35% had EILO.

While EILO can affect people of any age, it most commonly shows up in:

• Adolescents and teenagers — particularly those involved in competitive sports
• Young women — though the research on prevalence in males and females is mixed
• Elite and endurance athletes — whose training intensity puts repeated high demand on the airway

The Misdiagnosis Problem

Here’s where World ILO Day becomes so important: EILO is frequently mistaken for asthma.

Both conditions cause breathing difficulty during exercise. Both can involve a wheeze-like sound. But they are entirely different in origin, location, and treatment. Asthma involves the lower airways (the lungs and bronchi). EILO originates in the upper airway — specifically the larynx.

The consequences of misdiagnosis are real. Our clients often spend years using asthma inhalers that offer no relief. They may be told to limit their activity. Some stop playing sports altogether. Others develop anxiety around physical exertion. And because the condition is still under-recognized, many continue on this path without ever getting an accurate answer.

Treatment For EILO

The good news is that there are treatment options available for EILO.

Breathing retraining and speech therapy are considered first-line treatment. A speech-language pathologist can teach specific techniques to keep the larynx open and prevent obstruction during exercise. Functional breathing retraining helps athletes re-establish normal breathing patterns at rest and translate them in sport-specific environments. Inspiratory muscle training is another non-surgical option showing promise in clinical research.

For some patients with a specific subtype of EILO (supraglottic), endoscopic supraglottoplasty — a minimally invasive surgical procedure — has shown beneficial results and may be offered when conservative treatment is insufficient.

Treatment is most effective when individualized to the patient’s specific EILO subtype, which is another reason accurate diagnosis matters so much.

Why World ILO Day Matters

World ILO Day, observed every June 17, exists precisely to address the awareness around ILO and EILO.

Despite affecting millions globally, ILO conditions remain chronically underdiagnosed and understudied. Patients go years without answers. Clinicians without specific training may not recognize the signs. Asthma labels stick even when inhalers fail.

Raising awareness means:

• Patients knowing to ask: “Could this be EILO?”
• Parents recognizing that a child’s breathing problems during sports deserve thorough evaluation
• Medical providers adding EILO to the differential diagnosis for athletes with unexplained respiratory symptoms
• Healthcare systems investing in diagnostic tools and specialist training

Functional Airway Lab Can Help

If you or someone you know experiences breathing difficulty, specifically during peak-intensity exercise — especially if it comes with noisy breathing, throat tightness, and resolves quickly after stopping — it’s worth bringing up with a doctor, or contacting us to learn more about the next steps.

Contact Functional Airway Lab:

(805) 754-7768

functionalairwaylab.com