An exploratory study of the management strategies reported by endurance athletes with exercise-associated gastrointestinal symptoms

Rachel Scrivin; Ricardo J S Costa; Fiona Pelly; Dana M Lis; Gary Slater

doi:10.3389/fnut.2022.1003445

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An exploratory study of the management strategies reported by endurance athletes with exercise-associated gastrointestinal symptoms

Journal article

Open access

Peer reviewed

An exploratory study of the management strategies reported by endurance athletes with exercise-associated gastrointestinal symptoms

Rachel Scrivin, Ricardo J S Costa, Fiona Pelly, Dana M Lis and Gary Slater

Frontiers in Nutrition, Vol.9, pp.1-12

2022

DOI: https://doi.org/10.3389/fnut.2022.1003445

PMCID: PMC9691682

PMID: 36438762

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Abstract

Sports science and exercise

Athletes

Nutrition

gastrointestinal distress

exercise

dietary strategies

dietary fibre

gastroninestinal symptoms

questionnaire

Ex-GIS

low FODMAP

This exploratory study investigated endurance athletes self-reported exercise-associated gastrointestinal symptoms (Ex-GIS) and associated strategies to manage symptomology. Adult endurance athletes with a history of Ex-GIS (n = 137) participating in events ≥ 60 min completed an online validated questionnaire. Respondents included runners (55%, n = 75), triathletes (22%, n = 30), and non-running sports (23%, n = 32), participating at a recreationally competitive (37%, n = 51), recreationally non-competitive (32%, n = 44), and competitive regional/national/international (31%, n = 42) levels. Athletes identified when Ex-GIS developed most frequently either around training (AT), around competitions (AC), or equally around both training (ET) and competitions (EC). Athletes reported the severity of each symptom before, during, and after exercise. Athletes predominantly categorized Ex-GIS severity as mild (< 5/10) on a 0 (no symptoms) to 10 (extremely severe symptoms) visual analog symptomology scale. The Friedman test and post hoc analysis with Wilcoxon signed rank test was conducted with a Bonferroni correction applied to determine differences between repeated measures. The only severe symptom of significance was the urge to defecate during training in the ET group (Z = –0.536, p = 0.01). Ex-GIS incidence was significantly higher during training and competitions in all categories. A content review of self-reported strategies (n = 277) to reduce Ex-GIS indicated popular dietary strategies were dietary fiber reduction (15.2%, n = 42), dairy avoidance (5.8%, n = 16), and a low fermentable oligosaccharides, monosaccharides, and polyols (FODMAP) diet (5.4%, n = 15). In contrast, non-dietary strategies included the use of medications (4.7%, n = 13) and relaxation/meditation (4.0%, n = 11). On a Likert scale of 1–5, the most successful dietary strategies implemented were dietary fiber reduction (median = 4, IQR = 4, 5), low FODMAP diets (median = 4, IQR = 4, 5), dairy-free diets (median = 4, IQR = 4, 5), and increasing carbohydrates (median = 4, IQR = 3, 4). Accredited practicing dietitians were rated as the most important sources of information for Ex-GIS management (n = 29). Endurance athletes use a variety of strategies to manage their Ex-GIS, with dietary manipulation being the most common.

Details

Title: An exploratory study of the management strategies reported by endurance athletes with exercise-associated gastrointestinal symptoms
Authors: Rachel Scrivin (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
Ricardo J S Costa (Author) - Monash University
Fiona Pelly (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
Dana M Lis (Author) - University of California, Los Angeles
Gary Slater (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
Publication details: Frontiers in Nutrition, Vol.9, pp.1-12
Publisher: Frontiers Research Foundation
Date published: 2022
DOI: 10.3389/fnut.2022.1003445
PMID: 36438762; PMC9691682
Copyright note: © 2022 Scrivin, Costa, Pelly, Lis and Slater. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health - Nutrition & Dietetics; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99686898902621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Nutrition & Dietetics