R J S Costa1, R M J Snipe1, C M Kitic2, P R Gibson3. 1. Department of Nutrition Dietetics & Food, Monash University, Notting Hill, Victoria, Australia. 2. Sport Performance Optimisation Research Team, School of Health Sciences, University of Tasmania, Hobart, Tasmania, Australia. 3. Department of Gastroenterology- The Alfred Hospital, Monash University, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: "Exercise-induced gastrointestinal syndrome" refers to disturbances of gastrointestinal integrity and function that are common features of strenuous exercise. AIM: To systematically review the literature to establish the impact of acute exercise on markers of gastrointestinal integrity and function in healthy populations and those with chronic gastrointestinal conditions. METHODS: Search literature using five databases (PubMed, EBSCO, Web of Science, SPORTSdiscus, and Ovid Medline) to review publications that focused on the impact of acute exercise on markers of gastrointestinal injury, permeability, endotoxaemia, motility and malabsorption in healthy populations and populations with gastrointestinal diseases/disorders. RESULTS: As exercise intensity and duration increases, there is considerable evidence for increases in indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. The addition of heat stress and running mode appears to exacerbate these markers of gastrointestinal disturbance. Exercise stress of ≥2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest, irrespective of fitness status. Gastrointestinal symptoms, referable to upper- and lower-gastrointestinal tract, are common and a limiting factor in prolonged strenuous exercise. 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. CONCLUSIONS: Strenuous exercise has a major reversible impact on gastrointestinal integrity and function of healthy populations. The safety and health implications of prolonged strenuous exercise in patients with chronic gastrointestinal diseases/disorders, while hypothetically worrying, has not been elucidated and requires further investigation.
BACKGROUND: "Exercise-induced gastrointestinal syndrome" refers to disturbances of gastrointestinal integrity and function that are common features of strenuous exercise. AIM: To systematically review the literature to establish the impact of acute exercise on markers of gastrointestinal integrity and function in healthy populations and those with chronic gastrointestinal conditions. METHODS: Search literature using five databases (PubMed, EBSCO, Web of Science, SPORTSdiscus, and Ovid Medline) to review publications that focused on the impact of acute exercise on markers of gastrointestinal injury, permeability, endotoxaemia, motility and malabsorption in healthy populations and populations with gastrointestinal diseases/disorders. RESULTS: As exercise intensity and duration increases, there is considerable evidence for increases in indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. The addition of heat stress and running mode appears to exacerbate these markers of gastrointestinal disturbance. Exercise stress of ≥2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest, irrespective of fitness status. Gastrointestinal symptoms, referable to upper- and lower-gastrointestinal tract, are common and a limiting factor in prolonged strenuous exercise. 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. CONCLUSIONS: Strenuous exercise has a major reversible impact on gastrointestinal integrity and function of healthy populations. The safety and health implications of prolonged strenuous exercise in patients with chronic gastrointestinal diseases/disorders, while hypothetically worrying, has not been elucidated and requires further investigation.
Authors: Volker Scheer; Ricardo J S Costa; Stéphane Doutreleau; Beat Knechtle; Pantelis T Nikolaidis; William O Roberts; Oliver Stoll; Adam S Tenforde; Brian Krabak Journal: Sports Med Date: 2021-03-11 Impact factor: 11.136
Authors: Natasha A Koloski; Michael Jones; Marjorie M Walker; Gerald Holtmann; Nicholas J Talley Journal: United European Gastroenterol J Date: 2020-03-30 Impact factor: 4.623
Authors: Rhiannon M J Snipe; Anthony Khoo; Cecilia M Kitic; Peter R Gibson; Ricardo J S Costa Journal: Eur J Appl Physiol Date: 2017-12-12 Impact factor: 3.078
Authors: Nicholas B Tiller; Kirsty J Elliott-Sale; Beat Knechtle; Patrick B Wilson; Justin D Roberts; Guillaume Y Millet Journal: Sports Med Date: 2021-01-27 Impact factor: 11.136