n International SportMed Journal - The gastrointestinal system : the relationship between an athlete's health and sport performance : review article




Gastrointestinal (GI) problems are frequent in endurance athletes. The prevalence of such symptoms has been reported to be 30-50% among marathon runners. These GI problems occur more in running sports in comparison to activities with lower mechanical strain, such as cycling or swimming, where the vertical movement is limited. This observation suggests the theory that mechanical irritation could be one possible mechanism. <br>Furthermore, diminished perfusion of the splanchnic vessels during exercise, secretion of gastrointestinal hormones and other substances, as well as disturbed absorption, have been identified as being responsible for these symptoms. <br>In addition, external factors may be involved. As total body water is lost during exercise, sufficient rehydration is mandatory, especially in endurance activities, or during heat exposure. The choice and amount of fluid (containing carbohydrates and/or minerals) may modify the complaints. Nutrition itself may further contribute to gastrointestinal complaints, and considering the possible goals of an adequate nutrition may not only diminish these complaints but also lead to an improvement and maintenance of the athlete's health. <br>However, despite the high prevalence of these complaints, their aetiology in endurance athletes is still not fully understood. This article reviews possible pathophysiological interrelationships and therapeutic approaches to these GI symptoms.


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