Strenuous exercise may result in significant gastrointestinal symptoms. These may be severe enough to cause the athlete to discontinue the event.

Symptoms may include:

(1) reflux disease

(2) bloating

(3) belching

(4) epigastric or abdominal pain

(5) vomiting

(6) diarrhea or loose stools

(7) gastrointestinal bleeding

(8) flatulence

(9) colitis-like symptoms

(10) malabsorption


Risk factors for occurrence:

(1) prolonged exercise, especially an endurance sport

(2) high intensity

(3) heat stress


(5) lack of acclimatization

(6) dehydration or overhydration

(7) diet, especially overeating during exercise

(8) history of exercise-associated gastrointestinal symptoms


Proposed mechanisms:

(1) altered motility (delayed gastric emptying, change in intestinal transit times)

(2) damage to mucosa, including ischemia

(3) endotoxemia


Differential diagnosis:

(1) food poisoning

(2) other infection

(3) inflammatory bowel disease

(4) other gastrointestinal disorder

To read more or access our algorithms and calculators, please log in or register.