Exercise-related Transient Abdominal Pain Research Articles

Thorn in Your Side or Thorn in Your Head? Anxiety and Stress as Correlates of Exercise-Related Transient Abdominal Pain.

The etiology of exercise-related transient abdominal pain (ETAP) is not congruent among researchers notwithstanding numerous studies on the matter. No pursuit has sought to correlate ETAP with factors such as anxiety, stress, sleep dysfunction, and pain sensitivity that are linked to other gastrointestinal (GI) disturbances in athletes. Cross-sectional observational study involving an anonymous survey. Online. One hundred sixty-eight male and female adults running at least 10 miles/wk. Age, body mass index, years of running experience, GI symptoms, the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA), Perceived Stress Scale (PSS)-14, Sleep Problems Index-I, and Pain Sensitivity Questionnaire. Exercise-related transient abdominal pain prevalence over the past month as well as ETAP severity and frequency. Exercise-related transient abdominal pain occurred in 39.9% of participants at least once in the past month. Exercise-related transient abdominal pain-positive runners were significantly younger and less experienced than ETAP-negative runners. Exercise-related transient abdominal pain-positive runners demonstrated higher resting and running-related GI symptoms, PSS-14, and STICSA scores compared with ETAP-negative runners. After accounting for age and experience, the ETAP-positive group had STICSA and PSS-14 scores that were 3.4 [95% confidence interval (CI), 1.0-5.8] and 4.1 (95% CI, 1.2-6.0) points higher, respectively, than the ETAP-negative group. State-Trait Inventory for Cognitive and Somatic Anxiety scores were significantly, modestly correlated (ρ = 0.27, P = 0.03) with ETAP frequency but not severity in runners who were ETAP-positive. In runners, this is the first investigation to reveal that anxiety and stress are associated with the presence of ETAP.

Elastic Taping’s Effect on Exercise Capacity in Recreational Runner with Inspiratory Muscle Training

Background: Running is a new trend of recreational sports in Indonesia. About 70% of recreational runners have difficulty in improving exercise capacity due to exercise-related transient abdominal pain (ETAP), caused by fatigue of the diaphragmatic muscles. Previous studies have shown that various training methods may increase diaphragmatic muscle strength and endurance, for example, inspiratory muscle training (IMT). Unfortunately, improvement of inspiratory muscle strength and endurance after exercise and IMT are still varies. Therefore, other methods are needed to optimize the effect of IMT. Application of the elastic taping on thoracic wall during exercise allows the inspiratory muscles to contract optimally which might improve functional capacity.Aim: To assess the effect of elastic taping on inspiratory muscle training using the pressure threshold IMT, in increasing the functional exercise capacity of recreational runners. Functional capacity was measured based on VO2max value, rating of perceived breathlessness (RPB) and rating of perceived exertion (RPE).Methods: an experimental study involved 14 nonsmoker recreational runners, ages 20-40 years, at Outpatient Clinic of Physical Medicine and Rehabilitation Department of Dr. Soetomo Hospital Surabaya. Subjects were divided into two groups (pressure threshold IMT with and without elastic taping groups), which were observed for four weeks. IMT was done five times a week, twice a day, with 30 repetitions, and 60% resistance 30 RM using Respironics®. Elastic taping Leukotape® was applied on the first until fifth day in each IMT sessions. The running exercises were done three times a week with EnMill® Treadmill ETB-03195 with a speed of 4.5 mph and 0% inclination. RBP, RPE and VO2max were measured using Borg Dyspneu scale, Borg Scale, and Bruce Treadmill Protocol test, respectively, before the first exercise and after 4 weeks of exercise.Results: There were an improvement of functional exercise capacity in both groups which were marked with a decline of RPB and RPE and increase of VO2max (p values < 0.05). However, there were no significant differences in the decrease of RPB and RPE and an increase of VO2max between groups (p values of were 0.31, 0.83, and 0.13, respectively). The effect of the elastic taping (r2 = 0.99) was not reflected in the differences of RPB, RPE and increasing VO2max.Conclusion: Inspiratory muscle training using pressure threshold IMT with or without the elastic taping for four weeks can improve exercise capacity of recreational runners.

Elastic Taping’s Effect on Exercise Capacity in Recreational Runner with Inspiratory Muscle Training

Background: Running is a new trend of recreational sports in Indonesia. About 70% of recreational runners have difficulty in improving exercise capacity due to exercise-related transient abdominal pain (ETAP), caused by fatigue of the diaphragmatic muscles. Previous studies have shown that various training methods may increase diaphragmatic muscle strength and endurance, for example, inspiratory muscle training (IMT). Unfortunately, improvement of inspiratory muscle strength and endurance after exercise and IMT are still varies. Therefore, other methods are needed to optimize the effect of IMT. Application of the elastic taping on thoracic wall during exercise allows the inspiratory muscles to contract optimally which might improve functional capacity.Aim: To assess the effect of elastic taping on inspiratory muscle training using the pressure threshold IMT, in increasing the functional exercise capacity of recreational runners. Functional capacity was measured based on VO2max value, rating of perceived breathlessness (RPB) and rating of perceived exertion (RPE).Methods: an experimental study involved 14 nonsmoker recreational runners, ages 20-40 years, at Outpatient Clinic of Physical Medicine and Rehabilitation Department of Dr. Soetomo Hospital Surabaya. Subjects were divided into two groups (pressure threshold IMT with and without elastic taping groups), which were observed for four weeks. IMT was done five times a week, twice a day, with 30 repetitions, and 60% resistance 30 RM using Respironics®. Elastic taping Leukotape® was applied on the first until fifth day in each IMT sessions. The running exercises were done three times a week with EnMill® Treadmill ETB-03195 with a speed of 4.5 mph and 0% inclination. RBP, RPE and VO2max were measured using Borg Dyspneu scale, Borg Scale, and Bruce Treadmill Protocol test, respectively, before the first exercise and after 4 weeks of exercise.Results: There were an improvement of functional exercise capacity in both groups which were marked with a decline of RPB and RPE and increase of VO2max (p values < 0.05). However, there were no significant differences in the decrease of RPB and RPE and an increase of VO2max between groups (p values of were 0.31, 0.83, and 0.13, respectively). The effect of the elastic taping (r2 = 0.99) was not reflected in the differences of RPB, RPE and increasing VO2max.Conclusion: Inspiratory muscle training using pressure threshold IMT with or without the elastic taping for four weeks can improve exercise capacity of recreational runners.

A challenging diagnosis of exercise-related transient abdominal pain

A 17-year-old woman, high-performance triathlete, presented transient abdominal pain, face angioedema and sometimes syncope during exercise. Exercise-induced anaphylaxis was suspected at first. Allergic explorations with skin prick tests were negative but wheat flour specific IgE and recombinant rTri a14 (LTP) were weakly positive. However, wheat eviction did not improve the symptoms and stress test after wheat oral challenge did not show any signs of anaphylaxis. An abdominal ultrasound revealed peak expiratory velocities with a stenosis evaluated at 70 to 80 percent with turbulences in the celiac artery, confirmed by computed tomography angiogram. The diagnosis of exercise-induced median arcuate ligament syndrome (MALS) was retained and we discuss here the challenging diagnosis mimicking exercise-induced anaphylaxis.

Gastrointestinal Complaints and Correlations with Self-Reported Macronutrient Intake in Independent Groups of (Ultra)Marathon Runners Competing at Different Distances.

This study investigated the differences in gastrointestinal (GI) and exercise related complaints between groups of runners competing at different distances using web-based questionnaires. Total (severe) complaints were reported by 89.3% (49.7%) of the runners during the race vs. 70.6% (29.4%) after the race. Significant differences between groups were described for marathon (n = 98) and 60 km (n = 43) runners. During competition, runners reported the urge to urinate (47.7%), muscle cramps (43.6%) and belching (43.6%). The prevalence of bloating, flatulence, side ache and dizziness differed between distances (p < 0.02). There were small to moderate negative correlations between food and fluid intake and GI complaints. After competition (12 h), 70.6% of participants reported complaints, with muscle cramps (47.6%), flatulence (19.0%) and bloating (12.7%) being the most prevalent. Prevalence of belching, nausea, stomach cramps and muscle cramps differed between race distances (p < 0.04). There were small to high positive correlations between complaints during and after competition (p < 0.05). In conclusion, runners of all distances reported a high prevalence of GI and other exercise related complaints. There were some small differences in reporting type and severity of complaints between distances. Results showed small to strong correlations between complaints during and after competition and with nutrient intake, without a clear similar pattern for all distances.

The endurance athlete's "stitch": Etiology and management of exercise-related transient abdominal pain

Background: The endurance athlete's stitch, or exercise-related transient abdominal (ETAP), all too commonly limits the performance of endurance athletes, but its origin, management and possible methods of prevention remain unclear. Methods: Published research was reviewed systematically from January 1996 through May 2015.The terms Athletic Stitch, Pain in the side OR Abdominal pain were paired with Exercise/Exercise therapy, Physical education/Training, OR Fitness/Physical fitness to identify a total of 66 papers. 35 of these articles relevant to review objectives were supplemented by an additional 50 citations drawn from reference lists and personal files. Results : About a fifth of participants in aerobic endurance events are affected by ETAP on any one occasion, and perhaps two thirds of competitors experience ETAP at least once during a year. The risk seems greater in younger, less experienced and female athletes. Postulated causes that include visceral ischaemia, visceral vibration, ischaemia and/or spasm of the respiratory muscles, postural disorders, peritoneal irritation, and psychological factors.Treatment currently remains empirical. Optimizing physical condition, strengthening abdominal and spinal muscles, and avoiding food and hypertonic fluids immediately before an event appear to reduce the risks of ETAP. A slowing of pace, bending, local pressure and an abdominal binder may give immediate relief; the merits of spinal manipulation have yet to be confirmed Conclusions : Empirical remedies as yet have limited efficacy, and it remains necessary to develop a clear unifying hypothesis of etiology before evidence-based recommendations for the prevention and treatment of ETAP. Although ETAP may impair performance, it does not have any serious sequelae; the important objective for the practitioner is to distinguish it from other more dangerous causes of abdominal pain.

Median arcuate ligament syndrome in athletes

Exercise-related transient abdominal pain (ETAP) is a common entity in young athletes. Most occurrences are due to a "cramp" or "stitch," but an uncommon, and often overlooked, etiology of ETAP is median arcuate ligament syndrome (MALS). The initial presentation of MALS typically includes postprandial nausea, bloating, abdominal pain, and diarrhea, but in athletes, the initial presentation may be ETAP. We present a case series of three athletes who presented with exercise-related transient abdominal pain and were ultimately diagnosed and treated for MALS. Unlike other patients with median arcuate ligament syndrome, these athletes presented with exercise-induced pain, rather than the common postprandial symptoms. These symptoms persisted despite conservative measures. Work-up of patients with suspected MALS include a computed tomography or magnetic resonance angiography showing compression of the celiac artery with post-stenotic dilation, or a celiac artery ultrasound demonstrating increased velocities (>200cm/s2) with deep exhalation. All patients underwent a laparoscopic median arcuate ligament release. Postoperatively, there were no complications, and all were discharged home on postoperative day #2. All patients have subsequently returned to athletics with resolution of their symptoms. ETAP is common in athletes and often resolves with preventative or conservative strategies. When ETAP persists despite these methods, alternative causes, including MALS, should be considered. A combination of a thorough history and physical exam, as well as radiographic data, is essential to make the appropriate diagnosis and treatment strategy.

Exercise-related transient abdominal pain (ETAP).

Exercise-related transient abdominal pain (ETAP), commonly referred to as ‘stitch’, is an ailment well known in many sporting activities. It is especially prevalent in activities that involve repetitive torso movement with the torso in an extended position, such as running and horse riding. Approximately 70 % of runners report experiencing the pain in the past year and in a single running event approximately one in five participants can be expected to suffer the condition. ETAP is a localized pain that is most common in the lateral aspects of the mid abdomen along the costal border, although it may occur in any region of the abdomen. It may also be related to shoulder tip pain, which is the referred site from tissue innervated by the phrenic nerve. ETAP tends to be sharp or stabbing when severe, and cramping, aching, or pulling when less intense. The condition is exacerbated by the postprandial state, with hypertonic beverages being particularly provocative. ETAP is most common in the young but is unrelated to sex or body type. Well trained athletes are not immune from the condition, although they may experience it less frequently. Several theories have been presented to explain the mechanism responsible for the pain, including ischemia of the diaphragm; stress on the supportive visceral ligaments that attach the abdominal organs to the diaphragm; gastrointestinal ischemia or distension; cramping of the abdominal musculature; ischemic pain resulting from compression of the celiac artery by the median arcuate ligament; aggravation of the spinal nerves; and irritation of the parietal peritoneum. Of these theories, irritation of the parietal peritoneum best explains the features of ETAP; however, further investigations are required. Strategies for managing the pain are largely anecdotal, especially given that its etiology remains to be fully elucidated. Commonly purported prevention strategies include avoiding large volumes of food and beverages for at least 2 hours prior to exercise, especially hypertonic compounds; improving posture, especially in the thoracic region; and supporting the abdominal organs by improving core strength or wearing a supportive broad belt. Techniques for gaining relief from the pain during an episode are equivocal. This article presents a contemporary understanding of ETAP, which historically has received little research attention but over the past 15 years has been more carefully studied.

Nutritional indicators for gastrointestinal symptoms in female runners: the ‘Marikenloop study’

ObjectivesAmong runners the reported prevalence of exercise-induced gastrointestinal (GI) symptoms is high (25%–83%). We aimed to investigate the prevalence of GI symptoms in women during a 5–10 km run in...

The effect of transversus abdominis activation on exercise-related transient abdominal pain

Exercise-related transient abdominal pain (ETAP) affects 40-60% of the physically active population, is detrimental to performance but of unknown aetiology. Excessive movement of abdominal peritoneum is one proposed mechanism. Transversus abdominis (TrA) function may play a role reducing in the incidence of Exercise-related transient abdominal pain via the tensioning of the thoracolumbar fascia or increasing intra-abdominal pressure. The aim of this study is to identify any relationship between transversus abdominis function and exercise-related transient abdominal pain, hypothesing that those with stronger transversus abdominis will have lower incidence of exercise-related transient abdominal pain. Observational study design. Trunk muscle strength was measured clinically using the functional Sahrmann test. Contraction of transversus abdominis was measured by ultrasound imaging of resting muscle size and calculating the change in thickness with a voluntary contraction. Participants completed questionnaires describing any exercise-related transient abdominal pain symptoms, and were divided into four groups dependent upon frequency of any symptoms (never, yearly, monthly and weekly). Between group differences were analysed using analysis of covariance, with Bonferroni correction adjusting for age and training of participants using STATA. Poisson regression determined incident rate ratios for relevant variables. Data was obtained from fifty runners (28 male, 25.8 ± 7.0 years). Sahrmann test score and frequency of Exercise-related transient abdominal pain were significantly different between groups (p=0.002) with asymptomatic runners having significantly higher Sahrmann test scores (stronger muscles) than weekly and yearly Exercise-related transient abdominal pain groups (p=0.001, p=0.02). There were significant between group differences for resting transversus abdominis thickness (p=0.034) but not for transversus abdominis thickness change (p=0.555). Participants who had stronger trunk muscles and larger resting Transversus abdominis size experienced Exercise-related transient abdominal pain less.

Upper Gastrointestinal Issues in Athletes

Gastrointestinal (GI) complaints are common among athletes with rates in the range of 30% to 70%. Both the intensity of sport and the type of sporting activity have been shown to be contributing factors in the development of GI symptoms. Three important factors have been postulated as contributing to the pathophysiology of GI complaints in athletes: mechanical forces, altered GI blood flow, and neuroendocrine changes. As a result of those factors, gastroesophageal reflux disease (GERD), nausea, vomiting, gastritis, peptic ulcers, GI bleeding, or exercise-related transient abdominal pain (ETAP) may develop. GERD may be treated with changes in eating habits, lifestyle modifications, and training modifications. Nausea and vomiting may respond to simple training modifications, including no solid food 3 hours prior to an athletic event. Mechanical trauma, decreased splanchnic blood flow during exercise, and non-steroidal anti-inflammatory drugs (NSAID) contribute to gastritis, GI bleeding, and ulcer formation in athletes. Acid suppression with proton-pump inhibitors may be useful in athletes with persistence of any of the above symptoms. ETAP is a common, poorly-understood, self-limited acute abdominal pain which is difficult to treat. ETAP incidence increases in athletes beginning a new exercise program or increasing the intensity of their current exercise program. ETAP may respond to changes in breathing patterns or may resolve simply with continued training. Evaluation of the athlete with upper GI symptoms requires a thorough history, a detailed training log, a focused physical examination aimed at ruling out potentially serious causes of symptoms, and follow-up laboratory testing based on concerning physical examination findings.

Acute and Overuse Injuries of the Abdomen and Groin in Athletes

Abdominal and groin injuries are common problems encountered by athletes across a wide variety of sports. They range from benign but annoying, such as exercise-related transient abdominal pain (ETAP), to the activity-limiting and possibly career-ending condition of athletic hernia. This article covers ETAP, rectus abdominus injuries, osteitis pubis, athletic hernia, and abdominal/groin hernias to provide an update on the current pathophysiology and treatment of common abdominal and pelvic conditions in the athlete.

Influence of posture and body type on the experience of exercise-related transient abdominal pain

The aim of this study was to evaluate the influence of posture and body type on the experience of exercise-related transient abdominal pain (ETAP). Postural and somatotype assessments were performed on 104 active males and 55 active females aged 18.6 ± 0.4 years (mean ± SD) and were correlated against their self-reported experience of ETAP. Individuals demonstrating kyphosis were more likely to be susceptible to ETAP ( p < 0.01). Among the individuals susceptible to ETAP, the extent of kyphosis and lordosis influenced the pain severity ( p < 0.05). There was no relationship between any measure of body type and ETAP. The findings indicate that postural abnormality, particularly in the thoracic region, influences the experience of ETAP.

Exercise-related transient abdominal pain: Is it time to stitch up one of sports most common pains?

Purpose: Exercise-related transient abdominal pain, commonly referred to as ‘stitch’, is experienced in a diverse range of activities from running through to horse riding. The pain afflicts up to 30% of participants in a community fun run and approximately 60% of runners have experienced it within the past year. Despite the prevalence of the pain, it has received little research attention until recently. The purpose of this symposium is to overview the series of contemporary studies that have greatly advanced our understanding of the pain.

EMG activity is not elevated during exercise-related transient abdominal pain

Skeletal muscle cramp has been proposed as the aetiology of exercise-related transient abdominal pain (ETAP). The aim of this study was to determine whether or not localised electromyographic (EMG) activity indicative of skeletal muscle cramp is elevated during ETAP. Surface EMG activity was quantified at the site of ETAP in 14 symptomatic individuals (ETAP group) while the pain was present and after the pain subsided. Additionally, measurements were taken in another 14 subjects (Comparison group) who performed the same experimental procedure but did not experience ETAP. In the ETAP group, localised EMG activity did not increase when the pain was present or decrease when the pain subsided. The level of EMG activity detected while the pain was present was indistinguishable from noise (0.20+/-0.18microV). No difference was observed between the ETAP and Comparison groups in the level of localised EMG activity (p=0.89) at any time. After the pain subsided in the ETAP group, EMG activity was recorded at the site of the pain while the subjects performed a diaphragm-dependent sniff manoeuvre (8.3+/-0.7microV) and a maximum voluntary contraction of the abdominal muscles (17.5+/-0.7microV). It was concluded that ETAP is not associated with elevated EMG activity, suggesting that the pain is not the result of muscle cramping.

Spirometry Measurements During an Episode of Exercise-Related Transient Abdominal Pain

To determine whether changes in lung function are associated with exercise-related transient abdominal pain (ETAP). Twenty-eight subjects susceptible to ETAP performed a flow-volume loop before (pre) and after (post) treadmill exercise. Fourteen of the subjects developed symptoms of ETAP during the exercise and completed the flow-volume loop while the pain was present. The remaining 14 subjects reported no symptoms of ETAP. Forced inspiratory vital capacity was essentially unchanged from pre to post in both groups (ETAP group -0.8% +/- 5.1%, comparison group -0.9% +/- 6.5%). Peak inspiratory-flow rate increased in both the ETAP group (12.4% +/- 16.2%) and the comparison group (17.9% +/- 16.6%), but the difference between groups (-4.6%, standardized effect size [EF] = -0.17) was trivial. Forced expiratory vital capacity decreased by approximately 4% in both groups (ETAP group -3.9% +/- 3.3%, comparison group -4.0% +/- 5.1%). Small differences in the mean change from pre to post between groups were recorded for peak expiratory-flow rate (-7.4%, EF = -0.28) and the forced expiratory volume in the first second of the test (-4.4%, EF = -0.44). ETAP does not appear to be associated with reduced inspiratory performance, suggesting that the diaphragm is not implicated directly in the etiology of ETAP. Expiratory power might be slightly reduced during an episode of ETAP, but the magnitude of this effect is unlikely to compromise exercise performance.

Epidemiology of exercise-related transient abdominal pain at the Sydney city to Surf community run

A questionnaire was administered to 848 participants (76% runners, 24% walkers) at the conclusion of the 14 km City to Surf community run in order to investigate their experience of exercise-related transient abdominal pain (ETAP). Twenty-seven percent of respondents reported experiencing ETAP during the event, with the condition reported more frequently (p< 0.01) by runners (30%) than walkers (16%). ETAP was mostly described as well-localised (88%) and of an aching (25%), sharp (22%) or cramping (22%) sensation. The most commonly-reported sites of the pain were the right (46%) and left lumbar (23%) regions of the abdomen. Forty-two percent of the respondents who experienced ETAP reported that the pain was detrimental to their performance. Reports of ETAP decreased with age (r= -0.23, p< 0.01) but were unrelated to gender, body mass index or the time taken to complete the event. Among respondents who ran, those who consumed a large mass of food relative to body weight in the time interval 1-2 hr before the event were more likely to develop symptoms of ETAP (p < 0.05). The nutritional content of the pre-event meal did not influence the experience of ETAP. Sufferers of ETAP were more likely to experience nausea (r = 0.12, p< 0.01) and report shoulder tip pain (r= 0.14, p< 0.01). The results indicate that ETAP is a commonly experienced problem and provide insights into the cause of the complaint.

Gastrointestinal Discomfort during Intermittent High-Intensity Exercise: Effect of Carbohydrate–Electrolyte Beverage

This study investigated whether different beverage carbohydrate concentration and osmolality would provoke gastrointestinal (GI) discomfort during intermittent, high-intensity exercise. Thirty-six adult and adolescent athletes were tested on separate days in a double-blind, randomized trial of 6 % and 8 % carbohydrate-electrolytes (CHO-E) beverages during four 12-min quarters (Q) of circuit training that included intermittent sprints, lateral hops, shuttle runs, and vertical jumps. GI discomfort and fatigue surveys were completed before the first Q and immediately after each Q. All ratings of GI discomfort were modest throughout the study. The cumulative index for GI discomfort, however, was greater for the 8 % CHO-E beverage than for the 6 % CHO-E beverage at Q3 and Q4 (P < 0.05). Averaging across all 4 quarters, the 8 % CHO-E treatment produced significantly higher mean ratings of stomach upset and side ache. In conclusion, higher CHO concentration and osmolality in an ingested beverage provokes stomach upset and side ache.

Fluid Balance During Exercise in the Heat

1666 The negative effects of dehydration on health and performance are well documented, but hydration practices during exercise in the heat vary widely among athletes and physically active people; many allow themselves to become dehydrated, while others drink too much for their needs, with potentially negative consequences. There is little research on how personal beliefs and subjective feelings, such as the fear that drinking before or during exercise will cause exercise-related transient abdominal pain (STITCH), influence drinking behavior during exercise. PURPOSE: To assess fluid balance (FB) during moderate exercise in the heat and its association with beliefs regarding drinking fluids and other perceptions during exercise. METHODS: 93 physically active male college students exercised at 60% HRmax reserve for one hour. Each subject alternated stationary cycling, stair climbing, and Nordic Track® skiing in an environmental chamber at 30°C, 70% rh (WBGT = 26.8°C). Voluntary fluid intake (FI) of a cold (8–16°C) sports drink was monitored. Subjects were weighed nude and dry before and after the exercise session. Perceived importance of hydration (IMP) and actual practices, as well as side-stitch beliefs, were evaluated via questionnaire; perception of ambient HEAT, beverage palatability (PAL), stomach fullness (FULL), and gastrointestinal distress (GIPAIN) were assessed at times 25 and 55 min. RESULTS: Fluid balance was −0.14 ± 0.89% (mean ± SD) of initial body mass (bm) (range −2.38 to 2.84%), with a sweat rate (SR) of 1208.3 ± 381.7ml•h-1 and FI of 1132 ± 610 ml•h-1. FB was associated with FI (R2 = 0.73), SR (R2 = 0.08), and IMP (R2 = 0.07) (p<0.01), but not with STITCH, PAL, HEAT or GIPAIN (p>0.05). Overhydrated individuals (FB>0.3%bm) were shorter (p = 0.04) but not lighter (p = 0.33) than dehydrated subjects (FB<-0.3%bm). Their FI was much larger (1700.1 ± 610.7 vs 791.8 ± 451.4ml•h-1, p<0.0005), but their SR was only a little less (1112.8 ± 341.7 vs 1367.3 ± 415.4 ml•h-1, p = 0.01). No significant differences were found between subgroups in any other measure, including STITCH and IMP. CONCLUSION: Overhydration was much more strongly associated with overdrinking than with low sweat rates while IMP was a marginally significant predictor of FB. To maintain proper fluid balance, individuals would be better off relying on an objective drinking plan based on their measured sweat rates than on subjective feelings. Supported by the Gatorade Sports Science Institute and UCR-VI-245-97-002.

Factors influencing exercise-related transient abdominal pain

Exercise-related transient abdominal pain (ETAP) is a widely experienced but poorly understood problem. This study examined the influence of age, gender, body mass index (BMI), training status, and sporting activity on the experience of ETAP and shoulder tip pain (STP). STP may occur as a result of referred pain from tissues innervated by the phrenic nerve; these tissues are implicated in theories proposed to explain ETAP. A total of 965 regular sporting participants were surveyed from six sporting activities: running, swimming, cycling, aerobics, basketball, and horse riding. The prevalence (r = -0.28, P < 0.01) and severity (r = -0.17, P < 0.01) of ETAP decreased with age. Gender, BMI, and training status had no affect on the prevalence or severity of ETAP, but respondents who trained more frequently reported experiencing ETAP less often. Younger respondents were more inclined than the older respondents to report ETAP on the left side of the abdomen (P < 0.05). The prevalence (r = -0.11, P < 0.01) and severity (r = -0.37, P < 0.01) of STP decreased with age. STP was described as more severe (r = 0.23, P < 0.05) by respondents with high BMI values. Gender and training status had no influence on the experience of STP. Controlling for all other factors, ETAP was respectively 10.5 and 9 times more common (P < 0.01) in running and horse riding than cycling. STP was 13 times more common in running than cycling. Training status alters the frequency of occurrence of ETAP but has little effect on the incidence or severity of the pain. Further, ETAP and STP decrease with age but are not related to gender or BMI.