Conditions that may contribute to exercise-associated diarrhea:
(1) faster orocecal transit in some athletes
(2) hyperosmolal foods or liquids (with mannitol or other nonabsorbed molecule)
(3) lactose or fructose intolerance
(4) food poisoning
(5) infection (viral, bacterial, parasitic)
(6) laxative abuse
(7) hot peppers
(8) malabsorption
(9) inflammatory bowel disease (ulcerative colitis, Crohn's disease)
(10) diabetes mellitus
(11) hyperthyroidism
(12) drugs
(13) alternative health products
(14) exercise-induced anaphylaxis
(15) diverticulitis
(16) tumor (colon cancer, carcinoid tumor or VIPoma)
(17) loss of sphincter control with exhaustion
(18) anxiety
(19) ischemia
An evaluation may entail:
(1) evaluation of the athlete's usual response to exertion
(2) changes in the response to exercise over time
(3) specific exposures prior to and during an occurrence
(4) signs and symptoms when not exercising
If no underlying cause is found and exertion is presumed to be the cause, then consider:
(1) reducing the level of exertion
(2) loperamide
(3) proper selection of diet and drink prior to and during exercise
