Abstract
Exercise-associated gastrointestinal (GI) distress can negatively impact athletic performance and interfere with exercise training. Although there are a few universal underlying causes of GI distress, each symptom often has its own unique triggers and, therefore, its own prevention and management strategies. One of the most troubling GI symptoms an athlete can experience during training and competition is nausea/vomiting. The prevalence of nausea varies with several factors, two of the most important being exercise intensity and duration. Relatively brief, high-intensity exercise (e.g., sprinting, tempo runs) and ultra-endurance exercise are both associated with more frequent and severe nausea. The potential causes of nausea in sport are numerous and can include catecholamine secretion, hypohydration, heat stress, hyponatremia, altitude exposure, excessive fluid/food consumption, hypertonic beverage intake, pre-exercise intake of fatty- or protein-rich foods (especially in close proximity to exercise), prolonged fasting, various supplements (caffeine, sodium bicarbonate, ketones), certain drugs (antibiotics, opioids), GI infections, and competition-related anxiety. Beyond directly addressing these aforementioned causes, antiemetic drugs (e.g., ondansetron) may also be useful for alleviating nausea in some competitive situations. Given the commonness of nausea in sport and its potential impact on exercise performance, athletes and sports medicine practitioners should be aware of the origins of nausea and strategies for dealing with this troublesome gut complaint.
Highlights
Exercise- and competition-associated gastrointestinal (GI) distress is a common issue encountered by athletes across a broad range of sporting endeavors
One of the most concerning of these performance-altering GI symptoms is nausea, which can be defined as a feeling of sickness in the stomach marked by an urge to vomit
This study didn’t report on nausea individually, the results suggest the prevalence of nausea is unlikely to be dramatically higher during endurance running than cycling when exercise duration is taken into account
Summary
Exercise- and competition-associated gastrointestinal (GI) distress is a common issue encountered by athletes across a broad range of sporting endeavors. There have been numerous review articles on the issue of GI distress in sport and exercise e.g., [1,7,8,9] These articles generally took a broad perspective when looking at GI symptoms, neglecting to focus in detail on any given symptom. There may be some universal underlying causes of GI distress (e.g., reduced gut blood flow), each symptom often has its own unique triggers and, its own prevention and management strategies. Given this lack of focus on individual GI symptoms, the purpose of this article is to provide a narrative review of the prevalence, pathophysiology, and management strategies for exercise- and competition-associated nausea and vomiting
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