Sports Dietitians Australia and Ultra Sports Science Foundation Joint Position Statement: A Practitioner Guide to the Prevention and Management of Exercise-Associated Gastrointestinal Perturbations and Symptoms

Ricardo J. S. Costa; Stephanie K. Gaskell; Kayla Henningsen; Nikki A. Jeacocke; Isabel G. Martinez; Alice Mika; Volker Scheer; Rachel Scrivin; Rhiannon M. J. Snipe; Alice M. Wallett; Pascale Young

doi:10.1007/s40279-025-02186-6

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Sports Dietitians Australia and Ultra Sports Science Foundation Joint Position Statement: A Practitioner Guide to the Prevention and Management of Exercise-Associated Gastrointestinal Perturbations and Symptoms

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Sports Dietitians Australia and Ultra Sports Science Foundation Joint Position Statement: A Practitioner Guide to the Prevention and Management of Exercise-Associated Gastrointestinal Perturbations and Symptoms

Ricardo J. S. Costa, Stephanie K. Gaskell, Kayla Henningsen, Nikki A. Jeacocke, Isabel G. Martinez, Alice Mika, Volker Scheer, Rachel Scrivin, Rhiannon M. J. Snipe, Alice M. Wallett, …

Sports Medicine, Vol.55, pp.1097-1134

2025

DOI: https://doi.org/10.1007/s40279-025-02186-6

PMCID: PMC12106582

PMID: 40195264

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Abstract

Gastrointestinal Syndrome

Excercise

Hydration

Heat

cooling

Dietary and Nutritional Supplements

It is now well-established that exercise can disturb various aspects of gastrointestinal integrity and function. The pathophysiology of these perturbations, termed "exercise-induced gastrointestinal syndrome (EIGS)," can lead to exercise-associated gastrointestinal symptom (Ex-GIS) inconveniences. EIGS outcomes can impact physical performance and may lead to clinical manifestation warranting medical intervention, as well as systemic responses leading to fatality. Athlete support practitioners seek prevention and management strategies for EIGS and Ex-GIS. This current position statement aimed to critically appraise the role of EIGS and Ex-GIS prevention and management strategies to inform effective evidence-based practice and establish translational application. Intervention strategies with mostly consistent beneficial outcomes include macronutrient (i.e., carbohydrate and protein) intake and euhydration before and during exercise, dietary manipulation of fermentable oligo-, di-, and mono-saccharides and polyols (FODMAP), and gut training or feeding tolerance adjustments for the specific management of Ex-GIS from gastrointestinal functional issues. Strategies that may provide benefit and/or promising outcomes, but warrant further explorations include heat mitigating strategies and certain nutritional supplementation (i.e., prebiotics and phenols). Interventions that have reported negative outcomes included low-carbohydrate high-fat diets, probiotic supplementation, pharmaceutical administration, and feeding intolerances. Owing to individual variability in EIGS and Ex-GIS outcomes, athletes suffering from EIGS and/or support practitioners that guide athletes through managing EIGS, are encouraged to undertake gastrointestinal assessment during exercise to identify underlying causal and exacerbation factor/s, and adopt evidence-based strategies that provide individualized beneficial outcomes. In addition, abstaining from prevention and management strategies that present unclear and/or adverse outcomes is recommended.

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Title: Sports Dietitians Australia and Ultra Sports Science Foundation Joint Position Statement: A Practitioner Guide to the Prevention and Management of Exercise-Associated Gastrointestinal Perturbations and Symptoms
Authors: Ricardo J. S. Costa (Corresponding Author) - Monash University
Stephanie K. Gaskell - Monash University
Kayla Henningsen - Monash University
Nikki A. Jeacocke - Australian Institute of Sport
Isabel G. Martinez - Monash University
Alice Mika - Monash University
Volker Scheer - Ultra Sports Sci Fdn, Pierre Benite, France
Rachel Scrivin
Rhiannon M. J. Snipe - Deakin University
Alice M. Wallett - Australian Institute of Sport
Pascale Young - Monash University
Publication details: Sports Medicine, Vol.55, pp.1097-1134
Publisher: Adis International Ltd.
Date published: 2025
DOI: 10.1007/s40279-025-02186-6
ISSN: 1179-2035
PMID: 40195264; PMC12106582
Copyright note: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Data Availability: Data and materials presented within this review can be made available by contacting the corresponding author, at reasonable request.
Organisation Unit: External
Language: English
Record Identifier: 991127005002621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Sport Sciences