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Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease
journal contribution
posted on 2017-08-01, 00:00 authored by R J S Costa, Rhiannon SnipeRhiannon Snipe, C M Kitic, P R GibsonBACKGROUND: "Exercise-induced gastrointestinal syndrome" refers to disturbances of gastrointestinal integrity and function that are common features of strenuous exercise. AIM: To systematically review the literature to establish the impact of acute exercise on markers of gastrointestinal integrity and function in healthy populations and those with chronic gastrointestinal conditions. METHODS: Search literature using five databases (PubMed, EBSCO, Web of Science, SPORTSdiscus, and Ovid Medline) to review publications that focused on the impact of acute exercise on markers of gastrointestinal injury, permeability, endotoxaemia, motility and malabsorption in healthy populations and populations with gastrointestinal diseases/disorders. RESULTS: As exercise intensity and duration increases, there is considerable evidence for increases in indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. The addition of heat stress and running mode appears to exacerbate these markers of gastrointestinal disturbance. Exercise stress of ≥2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest, irrespective of fitness status. Gastrointestinal symptoms, referable to upper- and lower-gastrointestinal tract, are common and a limiting factor in prolonged strenuous exercise. While there is evidence for health benefits of moderate exercise in patients with inflammatory bowel disease or functional gastrointestinal disorders, the safety of more strenuous exercise has not been established. CONCLUSIONS: Strenuous exercise has a major reversible impact on gastrointestinal integrity and function of healthy populations. The safety and health implications of prolonged strenuous exercise in patients with chronic gastrointestinal diseases/disorders, while hypothetically worrying, has not been elucidated and requires further investigation.
History
Journal
Alimentary pharmacology and therapeuticsVolume
46Issue
3Pagination
246 - 265Publisher
John Wiley & SonsLocation
Chichester, Eng.Publisher DOI
ISSN
0269-2813eISSN
1365-2036Language
engPublication classification
C Journal article; C1.1 Refereed article in a scholarly journalCopyright notice
2017, John Wiley & Sons LtdUsage metrics
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No categories selectedKeywords
BiomarkersChronic DiseaseExerciseGastric EmptyingGastrointestinal DiseasesHumansIntestinal DiseasesIntestine, SmallPermeabilityScience & TechnologyLife Sciences & BiomedicineGastroenterology & HepatologyPharmacology & PharmacyIRRITABLE-BOWEL-SYNDROMEORAL GLUTAMINE SUPPLEMENTATIONGASTRIC MYOELECTRICAL ACTIVITYEXERTIONAL-HEAT STRESSCHAIN FATTY-ACIDSQUALITY-OF-LIFEVEIN BLOOD-FLOWLOW FODMAP DIETBOVINE COLOSTRUMPHYSICAL-ACTIVITY
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