Exercise-Induced Diarrhea - An Overview

Introduction

Exercising regularly can contribute to stronger bones, fewer heart problems, improved sleep habits, weight maintenance, and controlled blood sugar levels. However, exercising can occasionally lead to gastrointestinal symptoms. The gastrointestinal symptoms seen commonly after exercising are diarrhea, heartburn, nausea, and abdominal pain. While gastrointestinal symptoms can vary from one person to another, symptoms like diarrhea can become severe and affect exercise. Strenuous exercises and dehydration are the leading cause of gastrointestinal complaints in most athletes.

What Is Diarrhea?

Diarrhea is the watery and loose stool during a bowel movement. People with diarrhea pass abnormally loose stools more than three times a day. Usually, diarrhea does not last for more than a few days. If diarrhea lasts longer than a week, it can indicate a more severe disorder like persistent infection, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), etc.

What Is Exercise-Induced Diarrhea?

Diarrhea is commonly seen in people who work out for prolonged periods and run long distances. It can occur during or after extreme forms of exercise like weightlifting, cycling, and running. Diarrhea after exercising can be due to various factors like decreased digestive blood flow, abrupt movements to the digestive organs, and fluctuating digestive hormones. Certain exercises cause the food to travel faster than normal through the digestive tract. This can lead to decreased absorption of nutrients by the intestine and reduced reabsorption of water by the colon resulting in loose stools.

What Are the Triggering Factors of Exercise-Induced Diarrhea?

The triggering factors of exercise-induced diarrhea are as follows:

• Nutritional: The food consumed plays a vital role in the relationship between exercise and gastrointestinal symptoms like diarrhea. Specific nutrients like fats, extremely concentrated carbohydrate drinks, proteins, and fiber can lead to gastrointestinal symptoms during exercise.

• Disruptive Movements: Body movements during exercises like running can cause trauma and damage to the intestinal lining. These repetitive motions can lead to diarrhea or gastrointestinal bleeding.

• Ischemia: Ischemia is the shortage of oxygen in the tissues due to restricted blood supply. Strenuous exercises can increase the blood flow toward the working muscles resulting in a lack of blood flow to the gastrointestinal tract. Insufficient blood flow to the gastrointestinal tract can lead to ischemia. The lining of the small and large intestines gets damaged, leading to reduced function and increased leakiness of the gastrointestinal tract. Decreased blood flow can also lead to problems like malabsorption of water and nutrients or fast movement of food substances through the gastrointestinal tract resulting in diarrhea.

• Dehydration: Intense exercises can lead to loss of water and fluid from the body. This can result in severe body dehydration and diarrhea.

• Pregnancy: It is common to have digestive problems like diarrhea during pregnancy. Diarrhea during pregnancy can be caused due to various factors like prenatal vitamins, increased stress, fluctuating hormones, etc. Pregnant women with digestive concerns may experience an exacerbation of symptoms like diarrhea on working out.

What Are the Exercises That Can Induce Diarrhea?

The main cause of diarrhea during exercise is because blood flows away from the intestines and gets directed towards the legs or other body parts. The exercises that can disturb digestion and cause diarrhea are as follows:

• Running: Moving the body up and down during running can stir up the digestive system resulting in an urge to defecate. Most of the people who run experience diarrhea during or immediately after a prolonged run. This is due to the redirection of blood to the legs instead of the digestive system.

• Abs Workouts: People who do ab workouts focusing on the lower abdominals are more likely to experience diarrhea. This is because, during abs workouts, the digestive organs are stimulated and put under pressure resulting in stomachaches and diarrhea.

• Strenuous Exercises: Strenuous exercises for prolonged periods can lead to digestive concerns like diarrhea and leaky gut (a condition in which weakened intestinal walls can cause bacteria, partially digested food, or toxins to enter the bloodstream). Vigorous activities like cycling, dancing, swimming, skiing, aerobics, etc., can cause diarrhea.

How to Treat Exercise-Induced Diarrhea?

Usually, diarrhea goes away on its own within a few days. However, persistent diarrhea during exercise needs medical treatment. The treatment varies from person to person based on the severity of symptoms and age of the patient. The treatment options that can fasten the recovery are as follows:

• Schedule the Workouts: People with consistent bowel movements can schedule the workouts accordingly. But people with irregular bowel routines should design an exercise plan. This can be done by keeping track of their bowel movements for a few days to notice the pattern. They should make sure that they have access to a restroom at a particular time between the exercises.

• Decrease the Duration of the Exercise: People who experience diarrhea constantly between workouts should reduce the intensity and duration of their exercise. They should assess which workout plan will help them to get their digestion under control.

• Change in Food Habits: People who experience exercise-induced diarrhea should have easily digestible foods. The BRAT diet, which includes bananas, rice, applesauce, and toast, is a very good option. This diet helps to firm up the stool and prevent stomach irritation. Vegetable soups and lean meats also can be taken. Consuming probiotic-rich foods like plain yogurt or probiotic supplements will help replenish healthy gut bacteria. Drinks like kefir and kombucha also can be included in the diet.

• Medications: Over-the-counter medications like Loperamide help in controlling diarrhea. When taken before an intense exercise like running, it decreases stool frequency. It should not be taken frequently and has to be used only on occasions like competition days. Drugs like Atropine and Dicyclomine help in controlling abdominal cramps, reducing the urgency of bowel movements, and decreasing the discomfort associated with diarrhea.

How to Prevent Exercise-Induced Diarrhea?

The steps to prevent exercise-induced diarrhea are as follows:

• Avoid having food at least two hours before running.

• Do not have dairy products before working out, as the lactose intolerance effect can get intensified during exercise.

• Stay hydrated before starting any exercise session.

• Avoid gas-producing foods before workouts.

• Do not have spicy, fried, or fatty foods and protein powders before workouts, as they can cause stomach irritation.

• Do not have medications like Aspirin, Ibuprofen, or antibiotics before heavy exercises.

• Do not consume sports drinks that contain artificial sweeteners and fructose.

• Avoid wearing tight clothes like leggings or bike shorts as they can restrict the blood flow to the digestive system. Always wear loose-fitting clothes.

Conclusion

Gastrointestinal symptoms like diarrhea are common while working out. These symptoms are frequently seen in people like runners or athletes who engage in intense forms of exercise. Mostly these symptoms are harmless and go away on their own. Diarrhea that occurs frequently and affects the exercise routine requires attention. Reducing the intensity of the exercise, dietary changes, and staying hydrated helps in controlling exercise-induced diarrhea.