Abdominal Complaints and Gastrointestinal Function During Long-Lasting Exercise*

Brouns, Fred; Saris, W. H. M.; Rehrer, Nancy J.

doi:10.1055/s-2008-1025653

Cited by 107 publications

(45 citation statements)

References 60 publications

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“…This result is in agreement with a previous report of a higher prevalence of GI distress in half-marathon runners after gel administration compared with the use of water only (Burke et al, 2005). Symptoms reported in the current study included flatulencies, bloating, and the urge to defecate, which are common GI complaints in endurance sports (Brouns et al, 1987). A prevalence of GI distress of 3%-23% has been reported in running (Pfeiffer et al, 2009), and GI distress presents one of the leading causes of dropout in long-distance triathlon (Jeukendrup et al, 2000).…”

Section: Discussionsupporting

confidence: 93%

Carbohydrate Intake in Form of Gel Is Associated With Increased Gastrointestinal Distress but Not With Performance Differences Compared With Liquid Carbohydrate Ingestion During Simulated Long-Distance Triathlon

Sareban

Zügel

Koehler

et al. 2016

International Journal of Sport Nutrition and Exercise Metabolism

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The ingestion of exogenous carbohydrates (CHO) during prolonged endurance exercise, such as long-distance triathlon, is considered beneficial with regard to performance. However, little is known about whether this performance benefit differs among different forms of CHO administration. To this end, the purpose of our study was to determine the impact of CHO ingestion from a semisolid source (GEL) on measures of performance and gastrointestinal (GI) comfort compared with CHO ingestion from a liquid source (LIQ). Nine well-trained triathletes participated in this randomized crossover study. Each participant completed a 60-min swim, 180-min bike exercise, and a 60-min all-out run in a laboratory environment under 2 conditions, once while receiving 67.2 ± 7.2 g · h−1 (M ± SD) of CHO from GEL and once while receiving 67.8 ± 4.2 g · h−1 of CHO from LIQ. The amount of fluid provided was matched among conditions. Respiratory exchange ratio (RER), blood glucose, and lactate as well as GI discomfort were assessed at regular intervals during the experiment. The distance covered during the final all-out run was not significantly different among participants ingesting GEL (11.81 ± 1.38 km) and LIQ (11.91 ± 1.53 km; p = .89). RER, blood glucose, and lactate did not differ significantly at any time during the experiment. Seven participants reported GI discomfort with GEL, and no athlete reported GI discomfort with LIQ (p = .016). This study suggests that administration of GEL does not alter long-distance triathlon performance when compared with LIQ, but GEL seems to be associated with reduced GI tolerance. Athletes should consider this a potential disadvantage of GEL administration during long-distance triathlon.

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Section: Discussionsupporting

confidence: 93%

Carbohydrate Intake in Form of Gel Is Associated With Increased Gastrointestinal Distress but Not With Performance Differences Compared With Liquid Carbohydrate Ingestion During Simulated Long-Distance Triathlon

Sareban

Zügel

Koehler

et al. 2016

International Journal of Sport Nutrition and Exercise Metabolism

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“…Severe diarrhea and vomiting may occur with exertional heat stroke (151). Ultraendurance athletes often report GI problems such as intestinal cramps, diarrhea, or blood loss in the feces that may be indicative of increased intestinal permeability (60,177,300,302,364). The majority (∼81%) of runners participating in the Comrades Marathon showed high circulating endotoxin levels following completion of the race that correlated with the incidence of nausea, vomiting, and/or diarrhea (56).…”

Section: Gut Epithelial Permeability and Bacterial Translocationmentioning

confidence: 99%

Heat Stroke

Leon

Bouchama

2015

Comprehensive Physiology

360

356

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Heat stroke is a life-threatening condition clinically diagnosed as a severe elevation in body temperature with central nervous system dysfunction that often includes combativeness, delirium, seizures, and coma. Classic heat stroke primarily occurs in immunocompromised individuals during annual heat waves. Exertional heat stroke is observed in young fit individuals performing strenuous physical activity in hot or temperature environments. Long-term consequences of heat stroke are thought to be due to a systemic inflammatory response syndrome. This article provides a comprehensive review of recent advances in the identification of risk factors that predispose to heat stroke, the role of endotoxin and cytokines in mediation of multi-organ damage, the incidence of hypothermia and fever during heat stroke recovery, clinical biomarkers of organ damage severity, and protective cooling strategies. Risk factors include environmental factors, medications, drug use, compromised health status, and genetic conditions. The role of endotoxin and cytokines is discussed in the framework of research conducted over 30 years ago that requires reassessment to more clearly identify the role of these factors in the systemic inflammatory response syndrome. We challenge the notion that hypothalamic damage is responsible for thermoregulatory disturbances during heat stroke recovery and highlight recent advances in our understanding of the regulated nature of these responses. The need for more sensitive clinical biomarkers of organ damage is examined. Conventional and emerging cooling methods are discussed with reference to protection against peripheral organ damage and selective brain cooling.

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“…Increased circulating LPS levels in patients lead to various symptoms, such as fever, shivering, dizziness, nausea, various gastro-intestinal (GI) complaints such as vomiting and diarrhoea, and ultimately sepsis [8]. Such symptoms are also frequently reported by ultra-endurance athletes, in particular GI problems such as stomach cramps or stomach ache, intestinal cramps and diarrhoea [9][10][11]. The prevalence of such symptoms has been reported to be 30-50 % among marathon runners [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Relationship between gastro-intestinal complaints and endotoxaemia, cytokine release and the acute-phase reaction during and after a long-distance triathlon in highly trained men

et al. 1999

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A B S T R A C TThe aim of the present study was to establish whether gastro-intestinal (GI) complaints observed during and after ultra-endurance exercise are related to gut ischaemia-associated leakage of endotoxins [lipopolysaccharide (LPS)] into the circulation and associated cytokine production. Therefore we collected blood samples from 29 athletes before, immediately after, and 1, 2 and 16 h after a long-distance triathlon for measurement of LPS, tumour necrosis factor-α and interleukin-6 (IL-6). As the cytokine response would trigger an acute-phase response, characteristic variables of these responses were also measured, along with creatine kinase (CK) to obtain an indicator of muscle damage. There was a high incidence (93 % of all participants) of GI symptoms ; 45 % reported severe complaints and 7 % of the participants abandoned the race because of severe GI distress. Mild endotoxaemia (5-15 pg/ml) was evident in 68 % of the athletes immediately after the race, as also indicated by a reduction in IgG anti-LPS levels. In addition, we observed production of IL-6 (27-fold increase immediately after the race), leading to an acutephase response (20-fold increase in C-reactive protein and 12 % decrease in pre-albumin 16 h after the race). The extent of endotoxaemia was not correlated with the GI complaints or the IL-6 response, but did show a correlation with the elevation in C-reactive protein (r s 0.389 ; P l 0.037). Creatine kinase levels were increased significantly immediately post-race, and increased further in the follow-up period. Creatine kinase levels did not correlate with those of either IL-6 or C-reactive protein. It is therefore concluded that LPS does enter the circulation after ultra-endurance exercise and may, together with muscle damage, be responsible for the increased cytokine response and hence GI complaints in these athletes.

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Abdominal Complaints and Gastrointestinal Function During Long-Lasting Exercise*

Cited by 107 publications

References 60 publications

Carbohydrate Intake in Form of Gel Is Associated With Increased Gastrointestinal Distress but Not With Performance Differences Compared With Liquid Carbohydrate Ingestion During Simulated Long-Distance Triathlon

Carbohydrate Intake in Form of Gel Is Associated With Increased Gastrointestinal Distress but Not With Performance Differences Compared With Liquid Carbohydrate Ingestion During Simulated Long-Distance Triathlon

Heat Stroke

Relationship between gastro-intestinal complaints and endotoxaemia, cytokine release and the acute-phase reaction during and after a long-distance triathlon in highly trained men

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