Moderate to intense exercise has a variety of effects on the gut, including painful stabbing pains in the side of the abdomen, nausea, diarrhea, and even bleeding.
I’m training for a half marathon, but I’ve noticed a strange problem: every time I run more than a few miles, I get diarrheaWhy does this happen and how can I avoid it?
My athletic patients often say they need to take a break mid-run to answer an urgent call from nature. Compared to those who participate in other endurance sports, male runners seem to have worse GI symptoms, and younger female runners are at greater risk.
THE exercise moderate to intense has different effects on the intestineincluding a painful “pinching” on the side of the abdomen, as well as nausea, diarrhea, and even bleeding, microscopic or visible.
The latter case happened to Yohann Diniz, a French race walker, at the Rio de Janeiro Olympics in 2016. Diniz was the favorite to win the men’s 50-kilometer race. Halfway through the race, he started feeling sick. Then he had a stomach bug and, even more frightening, it looked like he was bleeding. Diniz passed out but, with some assistance, managed to get up and finish eighth. (Diniz’s story has a brighter sequence: he has continued to compete ever since and continues to hold the world record.)
The Effect of Physical Activity on the Gut
Exercise speeds up the rate at which the colon pushes its contents forward, which is why I advise my patients with constipation to get up and move around every morning. However, exercise can also relax the normally tight sphincter that connects the esophagus to the esophagus. stomach and slow the rate at which the stomach empties. These other changes can lead to worsening reflux and nausea.
Studies have found that when we’re pushing ourselves to the limit, blood flow to the intestines can decrease by up to 20% as our bodies divert blood to other places, like the leg muscles. In rare cases, low blood flow can lead to a problem where the colon doesn’t get enough oxygen, called ischemia, which triggers inflammation and bleeding. Fortunately, these episodes usually resolve on their own when you stop exercising.
One study found that 12% of long-distance runners pooped in their pants while running. Fecal incontinence can be caused by a combination of factors: the urgency of a spasmodic colon, along with the mechanical pressure of running, which can make it difficult to control the anal sphincter. If you have experienced this problem, talk to your doctor because you may benefit from pelvic floor physical therapy to strengthen these muscles.
How to Minimize Gastrointestinal Problems During Exercise
No one wants to see all their hard work go to waste on race day. So here are my tips from the gastroenterologist to minimize that risk:
- Avoid meals two or three hours before physical activity. Especially avoid high-fat meals fat or fiber, as they tend to take longer to digest and can worsen symptoms of nausea and acid reflux. Some people load up on carbohydrates the night before a sporting event. This is good for healthy people, as the carbohydrates will have passed through the stomach well before the next morning.
- During long workouts, avoid energy drinks, coffee and fruit juice. Instead, take small, frequent sips of hypotonic fluids. Hypotonic fluids, like many sports drinks, help quickly replace fluid and electrolyte losses through sweat. But hypertonic fluids – like soft drinksEnergy drinks and high fructose juices – should be avoided. They draw fluid from the bloodstream and into the intestines and can worsen the chances of dehydration and ischemia.
- Practice hydration during training, not just on race day. A study of more than 1,000 long-distance runners found that gastrointestinal symptoms were worse among those who didn’t practice hydration during training.
- Avoid drinking coffee immediately before running. Coffee is a powerful trigger for colon contractions. (Not the best thing when you only have access to portable toilets.)
- Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) for joint and muscle pain. FANS, like ibuprofentaken before exercise can increase damage to the intestinal lining, which is implicated in blood loss, at a time when the gastrointestinal tract is already under stress. Try acetaminophen (Tylenol), ice packs, or topical creams instead.
- Good night sleep and relax on race morning. Sleep disturbances and anxiety, especially on race morning, are associated with worsening gastrointestinal symptoms. The stress of travel and race logistics can trigger diarrhea. Waking up before dawn, panicking about your race not arriving, trying to find the race t-shirt pickup point—none of this is fun. If you can, arrive early to take these things into consideration and take some time for yourself before the big moment.
- Use data intelligently. If you have a smartwatch or other device that measures heart rate, check to see if you tend to experience nausea, cramps, or other GI symptoms when your heart rate goes above a certain threshold. Your gut may not be getting enough blood flow during high-intensity exercise. Use this data to recalibrate your workout goals to a safer range.
Finally, there is much debate over the best form of carbohydrate intake to improve performance during a race: solids, gels, or liquids. There is insufficient data on which form may be more beneficial to the gut, but some limited studies suggest that liquid forms may be gentler for people who experience gut symptoms during frequent exercise.
What I want my patients to know
Physical activity helps us maintain regularity and is associated with a 7% reduction in the risk of colorectal cancer.
However, I do not recommend pushing your body to its limits to achieve a goal that may not be healthy for you. When you feel nauseous during exercise, it is your body sending you a message. Take a break and see if you can continue. When you experience fecal incontinence or bleeding, it is your body asking you to stop what you are doing. Please answer this call.
*Trisha Pasricha is a professor of medicine at Harvard Medical School / TRANSLATION BY RENATO PRELORENTZOU
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
