Gastrointestinal symptoms during endurance running

Abstract

intestinal symptoms during endurance running. Scand J Med Sci Sports 1991: 1: 232-234.The incidence and type of gastrointestinal complaints among endurance runners were investigated with a questionnaire among participants in a marathon event in northern Finland. The running distances were %, % and full marathon. The fitness level of the participants varied from habitual joggers to national-class endurance runners. The response rate of the 426 participants was 55% (230). Gastrointestinal disturbances during the run were reported by 32% of the respondents. The prominent symptom during the % marathon was stitch (32%). The main complaints during the % marathon were stitch (21%), pain (12%), and retching or heartburn (5%). The most frequent symptoms during the full marathon were stitch (16%), pain (9%), diarrhoea (4%) and nausea (4%). Gastrointestinal symptoms hindered maximal performance subjectively for l6%, 18% and 19% in the %, ?4 and full marathon, respectively. Most of the symptomatic runners (73%) had suffered from gastrointestinal complaints during the preceding training period, and 25% of the asymptomatic runners reported previous gastrointestinal troubles during training.Endurance athletes often suffer from gastrointestinal symptoms during competition and training (1-5). The occurrence and frequency of gastrointestinal symptoms (1-3) seem to be related to the type and intensity of exercise as well as the fitness, age and gender of the athletes. The pathophysiological mechanisms of the origin of gastrointestinal symptoms of endurance athletes are largely unknown. Problems seem to occur more often during running than in such sports as swimming, cycling and cross-country skiing (2).The cause of stitch is still not understood, even though it is the most frequent symptom (2). Gastroesophageal reflux seems to be provoked during running (6,7); the urge to defecate and diarrhoea are mainly problems of long-lasting exercise (3).Although even massive gastrointestinal haemorrhages during exercise have been reported (8,9), the source of overt or occult gastrointestinal bleeding has usually remained obscure (3, 4, 10-12).Gastrointestinal bleeding is one possible explanation of "athlete's anaemia" (8-11, 13-15). In addition, for competitive athletes, gastrointestinal symptoms are especially harmful when they hinder maximal performance. The aim of this study was to examine the type and frequency of gastrointestinal symptoms among Finnish casual and competitive runners participating in a race. Material and methodsThe appearance of gastrointestinal symptoms was evaluated among 426 runners finishing a quarter, half or full marathon on 5 June 1989 in Oulu, Finland. A questionnaire about gastrointestinal symptoms was given to all participants immediately after they crossed the finish line. Questions were also asked about abdominal symptoms during training, training mileage during the preceding month, volume of fluids used during the race, finishing time, use of medicines during the last three days and previous abdominal investi...

Exercise-Related Transient Abdominal Pain (ETAP)

“…Therefore, the subjects in this study may not have reported less intense experiences of ETAP. Smaller studies have reported the incidence of ETAP to be 21 % for a 10-km event [ 15 ] and 19 % for a 67-km ultramarathon [ 4 ]. Hence, the body of evidence suggests that approximately one in five participants in a running event may be expected to experience ETAP.…”

“…A high level of physical conditioning may decrease the experience of ETAP [ 2 , 3 ]; however, the ailment is not unknown among well trained and even elite athletes [ 10 , 12 , 15 ]. Morton and Callister [ 1 ] observed well conditioned individuals to be as likely to report experiencing ETAP within the past year as less conditioned individuals and also to report pain of a similar severity, although better conditioned individuals reported experiencing the pain less frequently.…”

“…Exercise intensity has been suggested to influence ETAP [ 2 , 15 , 28 ] although the pain can clearly occur during activities of low intensity such as horse riding [ 1 ]. Morton et al [ 12 ] reported 31 % of runners experienced the pain during a walk/run event compared with only 16 % of walkers.…”

“…ETAP has been commonly referred to as a gastrointestinal disturbance [ 4 , 10 , 13 , 15 , 27 , 28 , 40 – 42 ] and is commonly the most prevalent symptom reported in studies of gastrointestinal complaints during exercise [ 4 , 15 ]. Despite being labeled a gastrointestinal disturbance, the etiology of the pain from a gastrointestinal perspective is poorly defined [ 15 , 41 , 43 ].…”

“…The few reports that have offered a gastrointestinal explanation for ETAP have focused on the pain originating from gut ischemia [ 13 , 15 , 36 , 44 ] or distension [ 36 ]. Supportive of an ischemic explanation for the pain, splanchnic blood flow decreases by up to 80 % during exercise [ 13 , 41 ].…”