Best Practice Case Studies-Case 127 Asset 1 Gastrointestinal Issues in Sport

Video Transcription

Video Summary

Dr. Kent Deduck’s lecture reviewed gastrointestinal issues in athletes from two angles: how exercise affects the GI tract and how GI problems affect athletic performance. He emphasized that sports medicine physicians must be “the medicine specialists” on sidelines and in clinics, not just MSK experts. GI symptoms are common, especially in endurance athletes, runners, women, and in hot conditions. Exercise reduces blood flow to the GI tract, contributing to reflux, cramps, bloating, diarrhea, and even occult blood loss. He argued that many traditional ideas are myths: the gut cannot really be “trained” to tolerate heavy fueling, hydration, or transit changes during exercise. Instead, athletes should fuel well before activity, minimize intake during competition, avoid NSAIDs, and use individualized dietary strategies. He highlighted FODMAPs as a promising approach, cautioned against unnecessary gluten-free or probiotic use, and warned that restrictive diets can mask eating disorders or RED-S. <br /><br />For acute GI illness, he recommended focusing on the “four F’s”: fluids, food, fever, and function. He also discussed choosing IV fluids based on the problem and using medications judiciously because exercise can alter absorption and increase side effects. Overall, he urged clinicians to assess symptoms carefully, consider red flags, and return athletes to play based on function.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 127

Topic Gastrointestinal

Keywords

4th Edition

4th Edition, Case 127

Gastrointestinal

gastrointestinal issues

athletes

exercise physiology

sports medicine

endurance athletes

FODMAPs

NSAIDs

RED-S

return to play