Sports Medicine

, Volume 26, Issue 6, pp 365–378 | Cite as

Aetiology of Running-Related Gastrointestinal Dysfunction

How Far is the Finishing Line?
  • Susana M. Gil
  • Etsuro YazakiEmail author
  • David F. Evans
Leading Article


30 to 65% of long distance runners experience gastrointestinal (GI) symptoms related to exercise. Several hypotheses have been postulated; however, the aetiology and pathophysiology are far from clear.

The mechanical effect of running on the viscera must be involved in the development of GI symptoms in this sport. Reduction of splanchnic blood flow due to visceral vasoconstriction is another widely supported theory; nevertheless, it does not explain many of the clinical findings. Examination of the GI tract during exercise is a difficult task, and measurements of both orocaecal and whole-gut transit time have shown equivocal results. GI hormones, and especially prostaglandins, may be of crucial importance for the production of symptoms. Intestinal absorption, secretion and permeability may also be altered during exercise, provoking intestinal dysfunction. Factors such as stress, diet, dehydration, infections and other factors need to be analysed in order to present a global view of the hypotheses regarding the aetiology of this common and often overlooked problem.


Adis International Limited Irritable Bowel Syndrome Vasoactive Intestinal Polypeptide Vasoactive Intestinal Polypeptide Motilin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Scobie BA. Athletes’ diarrhoea [letter]. N Z J Sports Med 1970; 6: 31Google Scholar
  2. 2.
    Fogoros RN. ‘Runner’s trots’: gastrointestinal disturbances in runners. JAMA 1980; 243 (17): 1743Google Scholar
  3. 3.
    Sullivan SN. The gastrointestinal symptoms of running. N Engl J Med 1981; 304 (15): 915PubMedGoogle Scholar
  4. 4.
    Sullivan SN, Wong C, Heindenheim P. Does running cause gastrointestinal symptoms? A survey of 93 randomly selected runners compared with controls. N Z Med J 1994; 107 (984): 328–31PubMedGoogle Scholar
  5. 5.
    Keefe EB, Lowe DK, Goss R, et al. Gastrointestinal symptoms of marathon runners. West J Med 1984; 141 (4): 481–4Google Scholar
  6. 6.
    Sullivan SN. Exercise-associated symptoms in triathletes. Phys Sports Med 1987; 15 (9): 106–10Google Scholar
  7. 7.
    Worobetz LJ, Gerrard DF. Gastrointestinal symptoms during exercise in enduro athletes: prevalence and speculations on the aetiology. N Z Med J 1985; 98 (784): 644–6PubMedGoogle Scholar
  8. 8.
    Riddoch C, Trinnick T. Gastrointestinal disturbances in marathon runners. Br J Sports Med 1988; 22: 71–4PubMedCrossRefGoogle Scholar
  9. 9.
    Priebe W, Priebe J. Runner’s diarrhoea – prevalence and clinical symptomatology. Am J Gastroenterol 1984; 79: 827–8Google Scholar
  10. 10.
    Sullivan SN, Wong C. Runner’s diarrhoea: different patterns and associated factors. J Clin Gastroenterol 1992; 14 (2): 101–4PubMedCrossRefGoogle Scholar
  11. 11.
    Brouns F, Beckers E. Is the gut an athletic organ? Digestion, absorption and exercise. Sports Med 1993; 15 (4): 242–57PubMedCrossRefGoogle Scholar
  12. 12.
    Green GA. Gastrointestinal disorders in the athlete. Clin Sports Med 1992; 11 (2): 453–68PubMedGoogle Scholar
  13. 13.
    Halvorsen FA, Lyng JL, Ritland S. Gastrointestinal bleeding in marathon runners. Scand J Gastroenterol 1986; 21: 493–7PubMedCrossRefGoogle Scholar
  14. 14.
    Moses FM. The effect of exercise on the gastrointestinal tract. Sports Med 1990; 9 (3): 159–72PubMedCrossRefGoogle Scholar
  15. 15.
    Rehrer NJ, Meijer GA. Biomechanical vibration of the abdominal region during running and bicycling. J Sports Med Phys Fitness 1991; 31 (2): 231–4PubMedGoogle Scholar
  16. 16.
    Peters HP, Van Schelven FW, Verstappen PA, et al. Gastrointestinal problems as a function of carbohydrate supplements and mode of exercise. Med Sci Sports Exerc 1993; 25: 1211–24PubMedGoogle Scholar
  17. 17.
    Fahrenkrug J. Nervous release of VIP in the gastrointestinal tract of the cats: possible physiological implications. J Physiol (Lond) 1978; 284: 291–305Google Scholar
  18. 18.
    Hubel KA. Intestinal nerves and ion transport: stimuli, reflexes, and responses. Am J Physiol 1985; 248: G261–71Google Scholar
  19. 19.
    Hossdorf T, Burger M, Karoff C, et al. Radioimmunoassay for vasoactive intestinal polypeptide (VIP) in plasma before and during endoscopic examinations. Hepatogastroenterology 1982; 29 (4): 146–50PubMedGoogle Scholar
  20. 20.
    Porter AW. Case report: marathon running and the caecal slap syndrome. Br J Sports Med 1982; 16 (3): 178PubMedCrossRefGoogle Scholar
  21. 21.
    Porter AW. Non-steroidal anti-inflammatory drugs and ethanol. Br J Sports Med 1982; 16: 265PubMedCrossRefGoogle Scholar
  22. 22.
    Dawson M. Psoas muscle hypertrophy: mechanical cause for jogger’s trots. BMJ 1985; 291: 787–8PubMedCrossRefGoogle Scholar
  23. 23.
    Pevett TL, ME Wilkins, WC Gamble. Caecal volvulus, a different twist for the serious runner. N Engl J Med 1985; 312: 1262–3Google Scholar
  24. 24.
    Rudzki SJ, Hazard H, Collinson D. GI blood loss in triathletes: its aetiology and relationship to sports anaemia. Aust J Sci Med Sport 1995; 27 (1): 3–8PubMedGoogle Scholar
  25. 25.
    Halvorsen F, Ritland S. Gastrointestinal problems related to endurance event training. Sports Med 1992; 14 (3): 157–63PubMedCrossRefGoogle Scholar
  26. 26.
    Baska RS, Moses FM, Deuster PA. Cimetidine reduces running associated GI bleeding: a prospective observation. Dig Dis Sci 1990; 35 (8): 56–60CrossRefGoogle Scholar
  27. 27.
    Robertson JD, Maughan RJ, Davidson RJ. Faecal blood loss in response to exercise. BMJ 1987; 295: 303–5PubMedCrossRefGoogle Scholar
  28. 28.
    Baska RS, Moses FM, Graeber G, et al. Gastrointestinal bleeding during an ultramarathon. Dig Dis Sci 1990; 35 (2): 276–9PubMedCrossRefGoogle Scholar
  29. 29.
    Schwartz AE, Vanagunas A, Kamel PL. Endoscopy to evaluate gastrointestinal bleeding in marathon runners. Ann Intern Med 1990; 113: 632–3PubMedGoogle Scholar
  30. 30.
    McCabe ME, Peura DA, Kadakia SC, et al. GI blood loss associated with running a marathon. Dig Dis Sci 1986; 31 (11): 1229–32PubMedCrossRefGoogle Scholar
  31. 31.
    Porter AW. Do some marathon runners bleed into the gut? BMJ 1983; 287: 1427PubMedCrossRefGoogle Scholar
  32. 32.
    McMahon LF, Ryan MJ, Larson D, et al. Occult gastrointestinal blood loss in marathon runners. Ann Intern Med 1984; 100 (6): 846–7PubMedGoogle Scholar
  33. 33.
    Worme JD, Doubt TJ, Singh A, et al. Dietary patterns, gastrointestinal complaints, and nutrition knowledge of recreational triathletes. Am J Clin Nutr 1990; 51 (4): 690–7PubMedGoogle Scholar
  34. 34.
    Stewart JG, Ahlquist DA, Mc Gill DB, et al. Gastrointestinal blood loss and anaemia in runners. Ann Intern Med 1984; 100: 843–5PubMedGoogle Scholar
  35. 35.
    Yges C, Chicharro JL, Lucia A, et al. Monoclonal antibodies for exercise-induced fecal occult blood detection – comparison with Hemofec. Can J Appl Physiol 1995; 20 (1): 78–88PubMedCrossRefGoogle Scholar
  36. 36.
    Wilhite J, Mellion MB. Occult gastrointestinal bleeding in endurance cyclists. Phys Sports Med 1990; 18 (8): 75–8Google Scholar
  37. 37.
    Dobbs TW, Atkins M, Ratcliff, et al. Gastrointestinal bleeding in competitive cyclists. Med Sci Sport Exerc 1988; 20 (2) Suppl. 5: S78Google Scholar
  38. 38.
    Selby G, Frame D, Eichner ER. Effort-related blood loss in young distance runners during a competitive season. Med Sci Sport Exerc 1988; 20 (2) Suppl. 5: S78Google Scholar
  39. 39.
    Moses FM, Baska RS, Peura DA, et al. Effect of cimetidine on marathon associated GI symptoms and bleeding. Dig Dis Sci 1991; 36 (10): 1390–4PubMedCrossRefGoogle Scholar
  40. 40.
    Alquist DA, McGill DB, Schwartz S, et al. HemoQuant, a new quantitative assay for faecal hemoglobin: comparison with haemoccult. Ann Intern Med 1984; 101: 297–302Google Scholar
  41. 41.
    Schentag JJ. False positive ‘Hemoccult’ reaction with cimetidine [letter]. N Engl J Med 1981; 303: 110Google Scholar
  42. 42.
    Macrae F, St John DJ, Caligiore P, et al. Optimal conditions for haemoccult testing. Gastroenterology 1982; 83: 860–3Google Scholar
  43. 43.
    Lampe JW, Slavin JL, Apple FS. Iron status of active women and the effect of running a marathon on bowel function and gastrointestinal blood loss. Int J Sports Med 1990; 12 (2): 173–9CrossRefGoogle Scholar
  44. 44.
    Papaioannides D, Giotis Ch, Karagiannis N, et al. Acute upper gastrointestinal haemorrhage in long-distance runners. Ann Intern Med 1984; 101: 719PubMedGoogle Scholar
  45. 45.
    Cooper BT, Douglas SA, Firth LA, et al. Erosive gastritis and gastrointestinal bleeding in a female runner. Gastroenterology 1987; 92: 2019–23PubMedGoogle Scholar
  46. 46.
    Gaudin C, Zerath E, Guezennec CY. Gastric lesions secondary to long distance running. Dig Dis Sci 1990; 35 (10): 1239–43PubMedCrossRefGoogle Scholar
  47. 47.
    Heer M, Repond F, Hany A, et al. Acute colitis in a female long distance runner. Gut 1987; 28: 896–9PubMedCrossRefGoogle Scholar
  48. 48.
    Cantwell JD. Gastrointestinal disorders in runners. JAMA 1981; 246 (13): 1404PubMedCrossRefGoogle Scholar
  49. 49.
    Beaumont AC, Teare JP. Subtotal colectomy following marathon running in a female patient. J R Soc Med 1991; 84: 439–40PubMedGoogle Scholar
  50. 50.
    Rubin RB, Saltzman JR, Zawacki JK. Bicycle racing, Raynaud’s phenomenon, and gastrointestinal bleeding. Am J Gastroenterol 1994; 89 (2): 291–2PubMedGoogle Scholar
  51. 51.
    Moses FM, Breuer TG, Peura DA. Running-associated proximal haemorrhagic colitis. Ann Intern Med 1988; 108: 385–6PubMedGoogle Scholar
  52. 52.
    Fisher RL, McMahon LF, Ryan MJ, et al. Gastrointestinal bleeding in competitive runners. Dig Dis Sci 1986; 31 (11): 1226–30PubMedCrossRefGoogle Scholar
  53. 53.
    Schoch DR, Sullivan AL, Grand RJ, et al. Gastrointestinal bleeding in an adolescent runner. J Pediatr 1987; 111 (2): 302–3PubMedCrossRefGoogle Scholar
  54. 54.
    Granger DN, Richardson, Kvietys PR. Intestinal blood flow. Gastroenterology 1980; 78: 837–63PubMedGoogle Scholar
  55. 55.
    Shepherd JT, Vanhoutte PM. Role of the venous system in circulatory control. Mayo Clin Proc 1978; 53 (4): 247–55PubMedGoogle Scholar
  56. 56.
    Clausen JP. Effect of physical training on cardiovascular adjustments to exercise in man. Physiol Rev 1978; 57: 779–815Google Scholar
  57. 57.
    Rowell LB, Blackmon JR, Bruce RA. Indocyanine green clearance and estimated hepatic blood flow during mild to maximal exercise in upright man. J Clin Invest 1964; 43: 1677–760PubMedCrossRefGoogle Scholar
  58. 58.
    Rowell LB, Blackmon JR, Martin RH, et al. Hepatic clearance of indocyanine green in man under thermal and exercise stress. J Appl Physiol 1965; 20 (3): 384–94PubMedGoogle Scholar
  59. 59.
    Rowell LB, Brengelmann GL, Blackmon JR, et al. Splanchnic blood flow and metabolism in heat-stressed man. J Appl Physiol 1968; 24 (4): 475–84PubMedGoogle Scholar
  60. 60.
    Kenney WL, Ho CW. Age alters regional distribution of blood flow during moderate-intensity exercise. J Appl Physiol 1995; 79 (4): 1112–9PubMedGoogle Scholar
  61. 61.
    Clausen JP, Klausen K, Rasmussen B, et al. Central and peripheral circulatory changes after training of the arms or legs. Am J Physiol 1973; 225 (3): 675–82PubMedGoogle Scholar
  62. 62.
    Ahlborg G, Weitzberg E, Sollevi A, et al. Splanchnic and renal vasoconstrictor and metabolic responses to neuropeptide Y in resting and exercising man. Acta Physiol Scand 1992; 145 (2): 139–49PubMedCrossRefGoogle Scholar
  63. 63.
    Ahlborg G. Lactate and glucose exchange across the forearms, legs, and splanchnic bed during and after prolonged leg exercise. J Clin Invest 1982; 69: 45–9PubMedCrossRefGoogle Scholar
  64. 64.
    Ahlborg G, Felig P, Hagenfeldt L, et al. Substrate turnover during prolonged exercise in man: splanchnic and leg metabolism of glucose, free fatty acids and amino acids. J Clin Invest 1974; 53: 1080–8PubMedCrossRefGoogle Scholar
  65. 65.
    Rehrer NJ, Smets A, Reynaert H, et al. Direct measurement of splanchnic blood flow during exercise in man. J Am Coll Sports Med 1987; 24 (5): S165Google Scholar
  66. 66.
    Qamar MI, Read AE. Effects of exercise on mesenteric blood flow in man. Gut 1987; 28: 583–7PubMedCrossRefGoogle Scholar
  67. 67.
    Flamm SD, Taki J, Moore R, et al. Redistribution of regional and organ blood volume and effect of cardiac function in relation to upright exercise intensity in healthy human subjects. Circulation 1990; 81: 1550–9PubMedCrossRefGoogle Scholar
  68. 68.
    Jost J, Weiss M, Weicker H. Sympathoadrenergic regulation and the adrenoceptor system. J Appl Physiol 1990; 68 (3): 897–904PubMedGoogle Scholar
  69. 69.
    Mailman D. Blood flow and intestinal absorption. Fed Proc 1982; 41 (6): 2096–100PubMedGoogle Scholar
  70. 70.
    Orhi SK, Bjarnason I, Pathi V, et al. Cardiopulmonary bypass impairs small intestine transport and increases gut permeability. Ann Thorac Surg 1993; 55 (5): 1080–6CrossRefGoogle Scholar
  71. 71.
    Rehrer NJ, Janssen GM, Brouns F, et al. Fluid intake and gastrointestinal problems in runners competing in a 25-km race and a marathon. Int J Sports Med 1989; 10 Suppl. 1: S22–5CrossRefGoogle Scholar
  72. 72.
    Sato N, Takenobu K, Motoaki S, et al. Measurement of hemoperfusion and oxygen sufficiency in gastric mucosa in vivo. Gastroenterology 1979; 76: 814–9PubMedGoogle Scholar
  73. 73.
    Gores GJ, Flarsheim LE, Dawson TL, et al. Swelling, reductive stress, and cell death during chemical hypoxia in hepatocytes. Am J Physiol 1989; 257: C347–54Google Scholar
  74. 74.
    Kingham JG, Whormell PJ, Lohery CA. Small intestinal permeability: effects of ischaemia and exposure to acetyl salicylate. Gut 1976; 17: 354–61PubMedCrossRefGoogle Scholar
  75. 75.
    Chiu CJ, McArdle AH, Brown R, et al. Intestinal mucosal lesion in low flow states. Arch Surg 1970; 101: 478–83PubMedCrossRefGoogle Scholar
  76. 76.
    Bulkley GB, Kvietys PR, Parks DA, et al. Relationship of blood flow and oxygen consumption to ischaemic injury in the canine small intestine. Gastroenterology 1985; 89: 852–7PubMedGoogle Scholar
  77. 77.
    Parks DA, Grogaard B, Granger DN. Comparison of partial and complete arterial occlusion models for studying intestinal ischaemia. Surgery 1982; 92: 896–901PubMedGoogle Scholar
  78. 78.
    Parks DA, Bulkley GB, Granger DN, et al. Ischaemic injury in the cat small intestine: role of superoxide radicals. Gastroenterology 1982; 82: 9–15PubMedGoogle Scholar
  79. 79.
    Granger DN, Rutili G, McCord JM. Superoxide radicals in the feline intestinal ischaemia. Gastroenterology 1981; 81: 22–9PubMedGoogle Scholar
  80. 80.
    Morishita T, Guth P. Effect of exogenous acid on the rat gastric mucosal microcirculation in haemorrhagic shock. Gastroenterology 1987; 92: 1958–64PubMedGoogle Scholar
  81. 81.
    Wilcox MG, Howard TJ, Plaskon LA, et al. Current theories of pathogenesis and treatment of nonocclusive mesenteric ischaemia. Dig Dis Sci 1995; 40 (4): 709–16PubMedCrossRefGoogle Scholar
  82. 82.
    Suvannapura A, Levens NR. Local control of mesenteric blood flow by the renin-angiotensin system. Am J Physiol 1988; 255 (3): G267–74Google Scholar
  83. 83.
    Bulkley GB, Oshima A, Bailey RW, et al. Control of gastric vascular resistance in cardiogenic shock. Surgery 1985; 98 (2): 213–23PubMedGoogle Scholar
  84. 84.
    Bailey RW, Bulkley GB, Hamilton SR, et al. Pathogenesis of nonocclusive ischaemic colitis. Ann Surg 1986; 203 (6): 590–9PubMedCrossRefGoogle Scholar
  85. 85.
    Aldigier JC, Huang H, Dalmay F, et al. Angiotensin-converting enzyme inhibition does not suppress plasma angiotensin II increase during exercise in humans. J Cardiovasc Pharmacol 1993; 21 (2): 289–95PubMedCrossRefGoogle Scholar
  86. 86.
    Ferrari R, Ceconi C, Rodella A, et al. Temporal relations of endocrine response to exercise. Cardioscience 1991; 2 (2): 131–9PubMedGoogle Scholar
  87. 87.
    Luger A, Deuster PA, Debolt JE, et al. Acute exercise stimulates the renin-angiotensin-aldosterone axis: adaptive changes in runners. Horm Res 1988; 30 (1): 5–9PubMedCrossRefGoogle Scholar
  88. 88.
    Szabo S. Mechanisms of gastric mucosal injury and protection. J Clin Gastroenterol 1991; 13 Suppl. 2: S21–34Google Scholar
  89. 89.
    Weitzberg E, Hemsen A, Lundberg JM, et al. ET-3 is extracted by and induces potent vasoconstriction in human splanchnic and renal vasculatures. J Appl Physiol 1995; 79 (4): 1255–9PubMedGoogle Scholar
  90. 90.
    Fukumura D, Kurose I, Miura S, et al. Role of endothelin-1 in repeated electrical stimulation-induced microcirculatory disturbance and mucosal damage in the rat stomach. J Gastroenterol Hepatol 1996; 11 (3): 279–85PubMedCrossRefGoogle Scholar
  91. 91.
    Dobi I, Kekesi V, Toth M, et al. Endothelin-induced long-lasting mesenteric vasoconstriction: a hypothetical mechanism of non-occlusive intestinal infarction. Acta Chir Hung 1991; 32 (3): 199–208PubMedGoogle Scholar
  92. 92.
    Maeda S, Miyauchi T, Waku T, et al. Plasma endothelin-1 level in athletes after exercise in a hot environment: exerciseinduced dehydration contributes to increases in plasma endothelin-1. Life Sci 1996; 58 (15): 1259–68PubMedCrossRefGoogle Scholar
  93. 93.
    Ahlborg G, Weitzberg E, Lundberg J. Metabolic and vascular effects of circulating endothelin-1 during moderately heavy prolonged exercise. J Appl Physiol 1995; 78 (6): 2294–300PubMedGoogle Scholar
  94. 94.
    Appenzeller O, Wood SC. Peptides and exercise at high and low altitudes. Int J Sports Med 1992; 13 Suppl. 1: S135–40CrossRefGoogle Scholar
  95. 95.
    Bounous G, McArdle AH. Marathon runners: the intestinal handicap. Med Hypotheses 1990; 33: 261–4PubMedCrossRefGoogle Scholar
  96. 96.
    McArdle W, Katch FI, Katch VL. Exercise physiology: energy, nutrition and human performance. Philadelphia: Lea & Febiger, 1991: 302Google Scholar
  97. 97.
    Sullivan SN. The effect of running on the gastrointestinal tract. J Clin Gastroenterol 1984; 6: 461–5PubMedCrossRefGoogle Scholar
  98. 98.
    Jordan PH, Boulafendis D, Guinn GA. Factors other than major vascular occlusion that contribute to intestinal infarction. Ann Surg 1970; 171: 189–94PubMedCrossRefGoogle Scholar
  99. 99.
    Bloom SR, Johnson RH, Park DM, et al. Differences in the metabolic hormonal response to exercise between racing cyclists and untrained individuals. J Physiol 1976; 258: 1–18PubMedGoogle Scholar
  100. 100.
    Sullivan SN, Champion MC, Christophides ND, et al. Gastrointestinal regulatory responses in long-distance runners. Phys Sportsmed 1984; 12 (7): 78–82Google Scholar
  101. 101.
    Modlin IM, Bloom SR, Mitchell S. Plasma vasoactive intestinal polypeptide (VIP) levels and intestinal ischaemia. Experientia 1978; 34: 535–6PubMedCrossRefGoogle Scholar
  102. 102.
    Barbezat GO, Grossmann MI. Intestinal secretion: stimulation by peptides. Science 1971; 174: 422–4PubMedCrossRefGoogle Scholar
  103. 103.
    Eklund S, Jodal M, Lundgren O, et al. Effects of vasoactive intestinal polypeptide on blood flow, motility and fluid transport of the gastrointestinal tract of the cat. Acta Physiol Scand 1979; 105 (4): 461–8PubMedCrossRefGoogle Scholar
  104. 104.
    Mailman D. Effects of vasoactive intestinal polypeptide on intestinal absortion and blood flow. J Physiol 1978; 279: 121–32PubMedGoogle Scholar
  105. 105.
    Kane MG, O’Dorisio TM, Krejs GJ. Production of secretory diarrhoea by intravenous infusion of vasoactive intestinal polypeptide. N Engl J Med 1983; 309: 1482–5PubMedCrossRefGoogle Scholar
  106. 106.
    Krejs GJ, Fordtran J. Effect of VIP on water and ion transport in the human jejunum. Gastroenterology 1980; 78: 722–7PubMedGoogle Scholar
  107. 107.
    Racusen LC, Binder HJ. Alteration of large intestinal electrolyte transport by vasoactive intestinal polypeptide in the rat. Gastroenterology 1977; 73: 790–6PubMedGoogle Scholar
  108. 108.
    Telford GL, Condon RE, Szurszewski JH. Opioid receptors and the initiation of migrating myoelectric complexes. Am J Physiol 1989; 256 (1): 672–7Google Scholar
  109. 109.
    Adachi H, Toda N, Nayashi S, et al. Mechanism of the excitatory action of motilin on isolated rabbit intestine. Gastroenterology 1981; 80: 783–8PubMedGoogle Scholar
  110. 110.
    Rennie JA, Christophides ND, Bloom SR, et al. Stimulation of human colonic activity by motilin [abstract]. Gut 1979; 20: A912Google Scholar
  111. 111.
    Suzuki T, Takahashi I, Itoh Z. Motilin and gallbladder: new dimensions in physiology. Peptides 1981; 2: 229–33PubMedCrossRefGoogle Scholar
  112. 112.
    Ahlborg G, Lundberg JM. Splanchnic release of neuropeptide Y during prolonged exercise with and without beta-adrenoceptor blockade in healthy man. Clin Physiol 1991; 11 (4): 343–51PubMedCrossRefGoogle Scholar
  113. 113.
    Buell MG, Harding RK. Effects of peptide YY on intestinal blood flow distribution and motility in the dog. Regul Pept 1989; 24 (2): 195–208PubMedCrossRefGoogle Scholar
  114. 114.
    Beubler E, Juan H. PGE release, blood flow and transmucosal water movement after mechanical stimulation of the rat jejunal mucosa. Naunyn Schmiedebergs Arch Pharmacol 1978; 305: 91–5PubMedCrossRefGoogle Scholar
  115. 115.
    Bennett A, Friedman CA, Vane JR. Release of prostaglandins E1 from the rat stomach. Nature 1967; 216: 873–6PubMedCrossRefGoogle Scholar
  116. 116.
    Gallavan RH, Jacobson ED. Prostaglandins and the splanchnic circulation. Proc Soc Exp Biol Med 1982; 170: 391–7PubMedGoogle Scholar
  117. 117.
    Demers LM, Harrison TS, Halbert DR, et al. Effect of prolonged exercise on plasma prostaglandin levels. Prostaglandins Med 1981; 6 (4): 413–8PubMedCrossRefGoogle Scholar
  118. 118.
    Hawkey CJ, Rampton DS. Prostaglandins and the gastrointestinal mucosa: are they important in its function, disease or treatment? Gastroenterology 1985; 89: 1162–88PubMedGoogle Scholar
  119. 119.
    Rush BD, Ruwart MJ. The role of accelerated colonic transit in prostaglandin-induced diarrhoea and its inhibition by prostacyclin. Br J Pharmacol 1984; 83 (1): 157–9PubMedCrossRefGoogle Scholar
  120. 120.
    Konturek SJ, Pawlik W. Physiology and pharmacology of prostaglandins. Dig Dis Sci 1986; 31 (2) Suppl. 2: 6S-19SCrossRefGoogle Scholar
  121. 121.
    Hunt RH, Dilawary JB, Misiewicz JJ. The effect of prostaglandin F2á and E2 on the motility of the sigmoid colon. Gut 1975; 16: 47–9PubMedCrossRefGoogle Scholar
  122. 122.
    Staumont G, Fioramonti J, Frexinos J, et al. Changes in colonic motility induced by sennosides in dogs: evidence of prostaglandin mediation. Gut 1988; 29: 1180–7PubMedCrossRefGoogle Scholar
  123. 123.
    Occhipinti M. Prostaglandins and gastrointestinal function. Adv Pediatr 1978; 25: 205–21PubMedGoogle Scholar
  124. 124.
    Milton-Thompson GJ, Cummings JH, Newman A, et al. Colonic and small intestinal response to intravenous prostaglandin F2á and E2 in man. Gut 1975; 1: 42–6CrossRefGoogle Scholar
  125. 125.
    Lange AP, Secher NJ, Amery W. Prostaglandin-induced diarrhoea treated with loperamide or diphenoxylate: a doubleblind study. Acta Med Scand 1977; 202 (6): 449–54PubMedCrossRefGoogle Scholar
  126. 126.
    Goodman G, Gilman A. The pharmacological basis of therapeutics. New York: Pergamon Press, 1985: 302Google Scholar
  127. 127.
    Samuelson B. Leukotrienes: mediators of immediate hypersensitivity reactions and inflammation. Science 1983; 220: 568–75CrossRefGoogle Scholar
  128. 128.
    Hua XY, Dahlen SE, Lundberg S, et al. Leukotrienes C4, D4 and E4 cause widespread and extensive plasma extravasation in the guinea-pig. Naunyn Schmiedebergs Arch Pharmacol 1985; 330: 136–41PubMedCrossRefGoogle Scholar
  129. 129.
    Whittle BJ. Prostaglandins and leukotrienes in gastrointestinal diseases. In: Domschke W, Dammann HG, editors. Prostaglandins and related compounds. New York: Springer-Verlag, 1988: 16Google Scholar
  130. 130.
    Barclay GR, Turnberg LA. Effect of moderate exercise on salt and water transport in the human jejunum. Gut 1988; 29: 816–20PubMedCrossRefGoogle Scholar
  131. 131.
    Williams JH, Milton Mager JR, Jacobson ED. Relationship of mesenteric blood flow to intestinal absortion of carbohydrates. J Lab Clin Med 1964; 63: 853–63PubMedGoogle Scholar
  132. 132.
    Peters HP, Akkermans LM, Bol E, et al. Gastrointestinal symptoms during exercise: the effect of fluid supplementation. Sports Med 1995; 20 (2): 65–75PubMedCrossRefGoogle Scholar
  133. 133.
    Fordtran JS, Saltin B. Gastric emptying and intestinal absorption during prolonged severe exercise. J Appl Physiol 1967; 23 (3): 331–5PubMedGoogle Scholar
  134. 134.
    Gisolfi CV, Spranger KJ, Summers RW, et al. Effects of cycle exercise on intestinal absorption in humans. J Appl Physiol 1991; 71 (6): 2518–27PubMedGoogle Scholar
  135. 135.
    Bosenberg AT, Brock-Utne JG, Gaffin SL, et al. Strenuous exercise causes systemic endotoxemia. J Appl Physiol 1988; 65 (1): 106–8PubMedGoogle Scholar
  136. 136.
    Cammack JN, Read W, Cann A, et al. Effect of prolonged exercise on the passage of a solid meal through the stomach and the small intestine. Gut 1982; 23: 957–62PubMedCrossRefGoogle Scholar
  137. 137.
    Keeling WF, Martin B. Gastrointestinal transit during mild exercise. J Appl Physiol 1987; 63 (3): 978–81PubMedGoogle Scholar
  138. 138.
    Keeling WF, Harris A, Martin BJ. Orocecal transit during mild exercise in women. J Appl Physiol 1990; 68 (4): 1350–3PubMedGoogle Scholar
  139. 139.
    Meshkinpour H, Kemp C, Fairshter R. Effect of aerobic exercise on mouth-to-cecum transit time. Gastroenterology 1989; 96: 938–41PubMedGoogle Scholar
  140. 140.
    Soffer EE, Summers RW, Gisolfi C. Effect of exercise on intestinal motility and transit time in trained athletes. Am J Physiol 1991; 260: G698–702Google Scholar
  141. 141.
    Koffler KH, Menkes A, Redmon RA, et al. Strength training accelerates gastrointestinal transit in middle-aged and older men. Med Sci Sports Exerc 1992; 24 (4): 415–9PubMedGoogle Scholar
  142. 142.
    Liu F, Toda Y. Brief physical inactivity prolongs colonic transit time in elderly men. Int J Sports Med 1993; 14: 465–7PubMedCrossRefGoogle Scholar
  143. 143.
    Bingham SA, Cummings JH. Effect of exercise and physical fitness on large intestinal function. Gastroenterology 1989; 97: 1389–99PubMedGoogle Scholar
  144. 144.
    Robertson G, Meshkinpour H, Cohen A, et al. Effects of exercise on total and segmental colon transit [abstract]. Gastroenterology 1990; 98 (5): A385Google Scholar
  145. 145.
    Coenen C, Wegener M, Wedman B, et al. Does physical exercise influence bowel transit time in healthy young men? Am J Gastroenterol 1992; 87 (3): 292–5PubMedGoogle Scholar
  146. 146.
    Oettle GJ. Effect of moderate exercise on bowel habit. Gut 1991; 32: 941–4PubMedCrossRefGoogle Scholar
  147. 147.
    Sesboue B, Arhan P, Devroede G, et al. Colonic transit in soccer players. J Clin Gastroenterol 1995; 20 (3): 211–4PubMedCrossRefGoogle Scholar
  148. 148.
    Rao KA, Evans DF. Gastrointestinal problems in athletes. Sports Exerc Injury 1995; 1: 183–90Google Scholar
  149. 149.
    Cheskin LJ, Crowell MD, Kamal N, et al. The effects of acute exercise on colonic motility. Gastrointest Motil 1992; 4: 173–7CrossRefGoogle Scholar
  150. 150.
    Dapoigny M, Sarna SK. Effect of physical exercise on colonic motor activity. Am J Physiol 1991; 260: G646–52Google Scholar
  151. 151.
    Cannon WB. The movements of the intestines studied by means of the Roentgen rays. Am J Physiol 1902; 6: 251–77Google Scholar
  152. 152.
    O’Brien JD, Thompson GD, Holly J, et al. Stress disturbs human gastrointestinal transit via a beta-1 adrenoceptor mediated pathway [abstract]. Gastroenterology 1985; 88: 1520Google Scholar
  153. 153.
    Valori RM, Kumar D, Wingate DL. Effects of different types of stress and ‘prokinetic’ drugs on the control of the fasting motor complexes in humans. Gastroenterology 1986; 90 (6): 1890–900PubMedGoogle Scholar
  154. 154.
    McRae S, Younger K, Thompsom DG, et al. Sustained mental stress alters human jejunal motor activity. Gut 1982; 23 (5): 404–9PubMedCrossRefGoogle Scholar
  155. 155.
    Narducci F, Snape WJ, Battle WM, et al. Increased colonic motility during exposure to a stressful situation. Dig Dis Sci 1985; 30: 40–4PubMedCrossRefGoogle Scholar
  156. 156.
    Barone FC, Deegan JF, Fowler PJ, et al. A model of stress-induced increased faecal output and colonic transit. Gastroenterology 1986; 90: 1337Google Scholar
  157. 157.
    Williams CL, Villar RG, Peterson JM, et al. Stress-induced changes in intestinal transit in the rat: a model for irritable bowel syndrome. Gastroenterology 1988; 94: 611–21PubMedGoogle Scholar
  158. 158.
    Lenz HJ, Raedler A, Greten H, et al. Stress-induced gastrointestinal secretory and motor responses in rats are mediated by endogenous corticotropin-releasing factor. Gastroenterology 1988; 95 (6): 1510–7PubMedGoogle Scholar
  159. 159.
    Bueno L, Gue M. Evidence for the involvement of corticotropinreleasing factor in the gastrointestinal disturbances induced by acoustic and cold stress in mice. Brain Res 1988; 441 (1–2): 1–4PubMedCrossRefGoogle Scholar
  160. 160.
    Van Erp-Barrt AM, Saris WH, Binkhorst RA, et al. Nationwide survey on nutritional habits in elite athletes: energy, carbohydrate and fat intake. Int J Sports Med 1989; 10 Suppl. 1: S3–7CrossRefGoogle Scholar
  161. 161.
    Harris A, Lindeman AK, Martin BJ. Rapid orocaecal transit in chronically active persons with high energy intake. J Appl Physiol 1991; 70 (4): 1550–3PubMedGoogle Scholar
  162. 162.
    Swain RA. Exercise induced diarrhoea: when to wonder. Med Sci Sports Exerc 1994; 26 (5): 523–6PubMedGoogle Scholar
  163. 163.
    Sharman IM. Gastrointestinal disturbances in runners. Br J Sports Med 1982; 16 (3): 179PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Susana M. Gil
    • 1
  • Etsuro Yazaki
    • 1
    Email author
  • David F. Evans
    • 1
  1. 1.St Bartholomew’s and the Royal London School of Medicine and DentistryLondonEngland

Personalised recommendations