Exacerbators and the endurance athlete

RICARDO COSTA: There exists certain extrinsic and intrinsic factors that can exacerbate exercise-induced gastrointestinal syndrome. That is, can exacerbate or make worse gastric emptying, intestinal motility or intestinal trafficking, intestinal epithelial damage, intestinal permeability, and endotoxemia, cytokinaemic response, malabsorption, and impairment in the intestinal transporters of nutrients. These include exercise intensity, duration, and mode, the fitness status of the participants, the environmental conditions where the exercise is being undertaken, if the individual has recently consumed or taken non-steroidal anti-inflammatory agents. There’s also some evidence to possibly suggest that the gut microbiome– so the total abundance of bacteria, the diversity, and their functionality together could impact on the individual’s response to exercise-induced gastrointestinal syndrome.

In addition to those, during prolonged endurance exercise, it is advised to consume carbohydrates during exercise as part of the guidelines and recommendations, with the aim to maintain blood sugar levels, provide a source of energy throughout that prolonged exercise, and also attenuate fatigue and enhance performance. However, if the consumption of foods and fluids during exercise is above the tolerance level of that individual– example, the ability of the gastric load emptying and the instestinal transfer and absorption of those nutrients, then that could lead to gastrointestinal symptoms.