Inducible Laryngeal Obstruction (ILO): What it is and How Speech Pathology Helps You Breathe Easier

Do you ever suddenly feel out of breath, like you just can’t get air in, especially during exercise, stress, or around smells like perfume or smoke? You’re not alone - and it doesn’t always mean your lungs are the problem.

These kinds of symptoms can come from a condition called Inducible Laryngeal Obstruction (ILO). At Kate Walker Co., we help people understand and manage ILO using evidence-based speech pathology, supporting you to feel confident in your breathing again.

What Is ILO?

ILO is a condition where the larynx (voice box) temporarily narrows or closes at the wrong time during breathing, especially when breathing in. This can make it feel like you are short of breath, tight in the throat, or struggling to catch your breath - even though your lungs and oxygen levels are often normal.

You might also hear ILO also called:

• Vocal Cord Dysfunction (VCD)

• Paradoxical Vocal Fold Movement (PVFM)

These terms all refer to the same phenomenon: the vocal folds (sometimes called vocal cords) closing when they should stay open during breathing. 

The condition has been recognised in many situations worldwide, from everyday life to sports settings, and it can mimic asthma or other breathing problems. 

What Does ILO Feel Like?

People with ILO may experience:

• Sudden breathlessness, often worse when breathing in

• A tight or choking feeling in the throat

• Noisy breathing such as wheezing or stridor (a high-pitched sound)

• Voice changes or a sensation of “not getting enough air”

• Quick onset and quick resolution once the trigger is gone

These symptoms can come on rapidly and may resemble asthma - but the cause is different.

Common Triggers for ILO

ILO symptoms are often triggered by:

• Exercise or physical exertion (sometimes called exercise-induced laryngeal obstruction)

• Smoke, strong smells or irritants

• Cold or dry air

• Stress, anxiety or strong emotions

• Respiratory infections or chronic cough

• Reflux or throat irritation

Everyone’s triggers can be different, and identifying them can be a key part of improving symptoms.

Why ILO Is NOT Asthma - Even if It Feels Like It

ILO often looks just like asthma - shortness of breath, wheezing or noisy breathing - but there are important differences:

• Standard asthma inhalers often don’t help with ILO symptoms

• Lung function can be normal during episodes

• Symptoms often come on and go quickly with triggers

• ILO may co-exist with asthma in many people (meaning someone can have both) 

This overlap is why ILO can be confusing, and why many people go years without the right diagnosis.

How Speech Pathology Helps with ILO

Research, including work by Professor Anne Vertigan and colleagues, shows that speech pathology is an effective first-line treatment for ILO.

Speech pathologists are experts in how the voice box moves, how breathing and voice work together, and how behaviours can be retrained.

Here’s how we help:

1. Understanding What’s Happening

We explain clearly what ILO is (and what it isn’t), how symptoms start, and why they feel the way they do - knowledge that often reduces fear and builds control.

2. Breathing Retraining

You’ll learn gentle, practical breathing strategies to help:

• Reduce throat tension

• Improve airflow

• Stay calm during triggers

These strategies can be practised in everyday life and during moments when symptoms arise.

3. Techniques to Reduce or Stop an Episode

You’ll be taught easy, reliable techniques to help your throat relax when symptoms begin - helping episodes settle faster.

4. Trigger Identification and Practical Management

Together, we explore your personal triggers and how to avoid or manage them safely.

5. Supporting Emotional and Nervous System Responses

Because stress and the nervous system can influence symptoms, we support tools and practices that help your body feel calm and regulated.

A Helpful Resource: The iLOVCD Toolkit

The iLOVCD Toolkit (https://ilovcdtoolkit.org/) is a comprehensive, clinician-led resource used internationally to understand, assess, and manage ILO / VCD. It includes:

• Clear explanations of ILO and how it behaves

• Information on diagnosis and assessment

• Speech pathology treatment strategies

• Resources for people experiencing symptoms

Many people find it helpful alongside their speech pathology care - especially for learning more about triggers and management options. 

When to Seek Support

You might find speech pathology helpful if:

• You have breathing symptoms that don’t respond to asthma treatment

• You experience throat tightness or noisy breathing

• Your symptoms come on rapidly with certain triggers

• You’re unsure what’s causing your breathlessness

Early support can lead to better control and confidence in your breathing.

Assessment May Involve a Multidisciplinary Team (MDT)

Because ILO can look similar to other breathing conditions, assessment often involves a multidisciplinary team (MDT) working together to ensure the right diagnosis and care.

This may include:

• Speech Pathologist - to assess breathing patterns, laryngeal function, and provide treatment

• ENT Specialist - to examine the larynx (often with a small camera)

• Respiratory Physician or GP - to assess lung health and rule out or manage asthma

Not everyone needs to see every professional, but collaboration helps ensure:

• Other conditions are ruled out

• ILO is accurately identified

• Care is well-coordinated and appropriate

If you feel you may be experiencing symptoms of Inducible Laryngeal Obstruction (ILO), consider booking an appointment with a speech pathologist who has experience in upper airway and breathing disorders.

A speech pathology assessment can help you:

• Make sense of your symptoms

• Identify possible triggers

• Learn practical strategies to support your breathing

• Decide what next steps may be helpful

Book an online speech pathology appointment with Kate Walker Co here