Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations

  title={Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations},
  author={Erick P. de Oliveira and Roberto Carlos Burini and Asker E. Jeukendrup},
  journal={Sports Medicine (Auckland, N.z.)},
  pages={79 - 85}
Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30–50 % of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological… 

Carbohydrate-Dependent, Exercise-Induced Gastrointestinal Distress

Training the gut with high intake of CHO may increase absorption capacity and probably prevent GI distress, and CHO mouth rinse may be a good strategy to enhance performance without using GI tract in exercises lasting less than an hour.

Changes in Intestinal Permeability in Symptomatic and Asymptomatic Runners

The lack of difference in intestinal permeability between the groups combined with the difference in symptom occurrence indicates thatestinal permeability changes alone do not account for symptom development, and an individual predisposition as the cause of symptoms rather than diet alone is indicated.

Gastrointestinal pathophysiology during endurance exercise: endocrine, microbiome, and nutritional influences

The link between the intestinal microbiome, the integrity of the gut epithelia, and the influence of nutrition and dietary supplementation strategies are explored, and detail on gut hormone and peptide secretion that could potentially contribute to GI distress symptoms in athletes are added.

Effects of exercise and hyperthermia on gastrointestinal dysfunction and symptoms in recreational athletes

The increase in GI permeability observed during exercise is likely to be caused by intestinal ischemia, rather than an increase in core temperature, and no association between intestinal permeability and GI symptoms appears to exist.

Training the Gut for Athletes

It is clear that “nutritional training” can improve gastric emptying and absorption and likely reduce the chances and/or severity of GI problems, thereby improving endurance performance as well as providing a better experience for the athlete.

Gastrointestinal symptoms in elite athletes: time to recognise the problem?

There has been less research in examining the prevalence of GI symptoms in other sports, particularly at elite level, which is surprising given that many of the factors associated with GI damage and symptoms are commonly associated with endurance sports.

The Psychobiological Etiology of Gastrointestinal Distress in Sport: A Review.

  • P. Wilson
  • Psychology
    Journal of clinical gastroenterology
  • 2019
Future work should attempt to confirm that experimentally inducing psychological stress results in the aforementioned GI problems during exercise, and studies are needed to determine how psychological stress impacts the tolerance to nutritional fueling and whether it worsens the GI permeability that normally occurs with exercise.

‘I think I’m gonna hurl’: A Narrative Review of the Causes of Nausea and Vomiting in Sport

Given the commonness of nausea in sport and its potential impact on exercise performance, athletes and sports medicine practitioners should be aware of the origins of nausea and strategies for dealing with this troublesome gut complaint.

Exercise and gastrointestinal symptoms: running-induced changes in intestinal permeability and markers of gastrointestinal function in asymptomatic and symptomatic runners

Running for 90 min at a challenging pace causes small intestinal damage and increases intestinal permeability, however, these alterations in GI function do not appear to correlate with the development of GI symptoms during running.

Low FODMAP: A Preliminary Strategy to Reduce Gastrointestinal Distress in Athletes

Preliminary findings suggest that short-term FODMAP reduction may be a beneficial intervention to minimize daily GI symptoms in runners with exercise-related GI distress.



The impact of physical exercise on the gastrointestinal tract

Strenuous exercise and dehydrated states would be the causes of gastrointestinal symptoms referred by 70% of the athletes, and Gut ischemiaWould be the main cause of nausea, vomiting, abdominal pain and (bloody) diarrhea.

Upper Gastrointestinal Issues in Athletes

Evaluation of the athlete with upper GI symptoms requires a thorough history, a detailed training log, a focused physical examination aimed at ruling out potentially serious causes of symptoms, and follow-up laboratory testing based on concerning physical examination findings.

The Effect of Exercise on the Gastrointestinal Tract

The study of the digestive tract during the stress of exercise is in its infancy and it is hoped that the awareness of symptoms and clinical difficulties encountered by active subjects will provoke additional study ofThe GI physiology of the active individual in health and disease.

Food-dependent, exercise-induced gastrointestinal distress

Among athletes strenuous exercise, dehydration and gastric emptying (GE) delay are the main causes of gastrointestinal (GI) complaints, whereas gut ischemia is the main cause of their nausea,

Gastrointestinal profile of symptomatic athletes at rest and during physical exercise

There is no difference in GI profile between symptomatic and asymptomatic athletes at rest, but during exercise, symptomatic subjects have a longer OCTT and a higher intestinal permeability, which is more pronounced during running than during cycling.

Is the Gut an Athletic Organ?

Results of field and laboratory studies show that pre-exercise ingestion of foods rich in dietary fibre, fat and protein, as well as strongly hypertonic drinks, may cause upper GI symptoms such as stomach ache, vomiting and reflux or heartburn, but there is no evidence that the ingestion of nonhypertonic drink during exercise induces GI distress and diarrhoea.

Exercise-associated intestinal ischemia

  • F. Moses
  • Medicine
    Current sports medicine reports
  • 2005
Patients or athletes with recurrent symptoms of abdominal pain and diarrhea during exercise may be at increased risk for ischemic damage, however, no underlying anatomic abnormalities have been noted.

Physiology and pathophysiology of splanchnic hypoperfusion and intestinal injury during exercise: strategies for evaluation and prevention.

This review provides an overview on the recent advances in the understanding of GI physiology and pathophysiology in relation to strenuous exercise and elaborate on several promising components that could be exploited for preventive interventions.

Training the gut for competition

  • R. Murray
  • Medicine
    Current sports medicine reports
  • 2006
Proper training and nutrition minimize the risk of gastrointestinal discomfort during exercise by assuring rapid gastric emptying and absorption of water and nutrients and by maintaining adequate perfusion of the splanchnic vasculature.

Effects of dehydration on gastric emptying and gastrointestinal distress while running.

The high prevalence of GI disorders in marathon runners who have lost greater than or equal to 4% body weight supports the theory that ingestion may be occurring after dehydration has taken place, and dehydration in combination with endurance running, on gastric emptying and frequency of gastrointestinal complaints is tested.