Strenuous exercise may exacerbate gastrointestinal disorders

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Experts say intense exercise could be detrimental for patients with inflammatory bowel disease.

Findings from a new study suggest individuals who exercise excessively may be prone to acute or chronic gut issues.

The review, published in Alimentary Pharmacology and Therapeutics , found there is considerable evidence that increasing intensity and duration of exercise increases indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. This was exacerbated by heat stress.

Irrespective of an individual’s fitness status, exercise stress for at least 2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest.

The review also found that while there is evidence for health benefits of moderate exercise in patients with inflammatory bowel disease or functional gastrointestinal disorders, the safety of more strenuous exercise has not been established, but could be hypothetically detrimental.

The authors identified several strategies to prevent or reduce the severity of exercise-associated gastrointestinal perturbations including consumption of carbohydrate during exercise, avoidance of NSAIDs, and the use of dietary supplementation.

“It is recommended that a full gut assessment during exercise should be undertaken by individuals with symptoms of gut disturbances during exercise, to ascertain what is causing the issue and to develop individually tailored management strategies,” said lead author Dr. Ricardo Costa, lead author.

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