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Exercise-Induced Diarrhea, Sports Medicine

Steven K. Poon, MD, CAQSM and Kimberly G. Harmon, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Increased stool frequency or volume often accompanied by lower abdominal cramping or urge to defecate associated with strenuous physical activity:

    • Normal physical examination

    • Normal la...

DIAGNOSIS

HISTORY

  • Increased stool frequency or volume, or loose stools after exercise

  • Often accompanied by abdominal cramping and urge to defecate

  • May occur just with competition and not with training

  • Nor...

TREATMENT

GENERAL MEASURES

  • Treatment is generally conservative and should include 1,2,3[C]:

    • Training modification:

      • Increase volume and intensity of training slowly.

    • Try to evacuate prior to exercise.

    • Diet ...

ONGOING CARE

DIET

Dietary modification can be helpful 1,2,3,5[C]: 
  • Stay well hydrated.

  • Avoid caffeine, which is both a diuretic and a cathartic.

  • Avoid foods that exacerbate symptoms (e.g., lactose in lact...

REFERENCES

1
Casey E, Mistry DJ, MacKnight JM. Training room management of medical conditions: sports gastroenterology. Clin Sports Med.  2005;24(3):525–540.
2
Ho GW. Lower gastrointestinal distress...

ADDITIONAL READING

  • Green GA. Gastrointestinal disorders in the athlete. Clin Sports Med.  1992;11(2):453–470.

  • Swain RA. Exercise-induced diarrhea: when to wonder. Med Sci Sports Exerc.  1994;...

CLINICAL PEARLS

  • Exercise-induced diarrhea is associated with strenuous exercise and can worsen with increasing distance or intensity.

  • Symptoms are self-limited, and patients are often asymptomatic afte...

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