Carbohydrate-Dependent, Exercise-Induced Gastrointestinal Distress

Centre for Physical Exercise and Nutrition Metabolism, UNESP School of Medicine, Public Health Department, Botucatu City, São Paulo State, Brazil. .
Journal of the International Society of Sports Nutrition (Impact Factor: 1.5). 09/2011; 8(10):12. DOI: 10.1186/1550-2783-8-12
Source: PubMed

ABSTRACT Among athletes strenuous exercise, dehydration and gastric emptying (GE) delay are the main causes of gastrointestinal (GI) complaints, whereas gut ischemia is the main cause of their nausea, vomiting, abdominal pain and (blood) diarrhea. Additionally any factor that limits sweat evaporation, such as a hot and humid environment and/or body dehydration, has profound effects on muscle glycogen depletion and risk for heat illness. A serious underperfusion of the gut often leads to mucosal damage and enhanced permeability so as to hide blood loss, microbiota invasion (or endotoxemia) and food-born allergen absorption (with anaphylaxis). The goal of exercise rehydration is to intake more fluid orally than what is being lost in sweat. Sports drinks provide the addition of sodium and carbohydrates to assist with intestinal absorption of water and muscle-glycogen replenishment, respectively. However GE is proportionally slowed by carbohydrate-rich (hyperosmolar) solutions. On the other hand, in order to prevent hyponatremia, avoiding overhydration is recommended. Caregiver's responsibility would be to inform athletes about potential dangers of drinking too much water and also advise them to refrain from using hypertonic fluid replacements.

1 Follower
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Probiotic supplementation has traditionally focused on gut health. However, in recent years, the clinical applications of probiotics have broadened to allergic, metabolic, inflammatory, gastrointestinal and respiratory conditions. Gastrointestinal health is important for regulating adaptation to exercise and physical activity. Symptoms such as nausea, bloating, cramping, pain, diarrhoea and bleeding occur in some athletes, particularly during prolonged exhaustive events. Several studies conducted since 2006 examining probiotic supplementation in athletes or highly active individuals indicate modest clinical benefits in terms of reduced frequency, severity and/or duration of respiratory and gastrointestinal illness. The likely mechanisms of action for probiotics include direct interaction with the gut microbiota, interaction with the mucosal immune system and immune signalling to a variety of organs and systems. Practical issues to consider include medical and dietary screening of athletes, sourcing of recommended probiotics and formulations, dose-response requirements for different probiotic strains, storage, handling and transport of supplements and timing of supplementation in relation to travel and competition.
    European Journal of Sport Science 10/2014; 15(1):1-10. DOI:10.1080/17461391.2014.971879 · 1.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Anaphylaxis is a dramatic clinical emergency. It is a very severe, life-threatening generalized or systemic hypersensitivity reaction. Based on immunologic mechanism the anaphylaxis is divided in IgE, IgG, complement, or immune complexes-mediated vs non allergic anaphylaxis. There are a lot of etiologic factors of anaphylaxis, but the three principal immunologic triggers are drugs, insect stings, and foods. Regarding the clinical severity there are several proposed grading systems. The diagnosis of anaphylaxis is mainly clinical. The anaphylaxis markers measured in clinical laboratories are total tryptase and histamine. There are some conditions that modulate the onset of anaphylaxis, acting as co- or augmentation factors, which significantly lower the allergen dose necessary for triggering anaphylaxis. The well-documented cofactors of anaphylaxis are physical exercise, alcohol consumption, some foods, co-administration of nonsteroidal anti-inflammatory drugs (NSAID), and concomitant infectious diseases. Development of anaphylaxis depends on the sensitization pattern, the proportion of the involved immunoglobulin classes, characteristics of the allergen, the proportion of the involved immunoglobulin classes, the avidity and affinity of immunoglobulins to bind an allergen, the route of allergen application, and, last but not least, the presence of cofactors of anaphylaxis. Anaphylaxis remains a continuous challenge for the diagnosis and treatment. The adequate management of anaphylaxis requires rapid diagnosis, implementation of primary and secondary prevention measures, and immediate administration of subcutaneous epinephrine.
    Materia Socio Medica 12/2014; 26(6):401-4. DOI:10.5455/msm.2014.26.401-404
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Brain tumors are quite frequent cause of symptomatic epilepsy. This study aims to investigate: 1. The frequency of the appearance of epilepsy in patients with brain tumors. 2. Comparison of the frequency of occurrence of epilepsy as a result of malignant tumors and benign tumors. 3. Role of gliosis in the appearance of epileptic seizures Methodology: It is analyzed documentation of 6846 patients with various neurological diseases, which are examined during the period January 2012 - December 2013, of whom 4952 (72%) were examined at the Neurology Clinic of the University Clinical Center of Kosova, while 1894 (28%) were examined at the Diagnostic Center “Medica”. From the total of 6846 patients, 805(11.8%) were with epilepsy. The number of patients included in the study is 110 patients, all of them with partial epilepsy. These patients have fulfilled criteria for inclusion in the study (regular specialistic visits, realization of EEG and brain imaging CT ore/and MRI). The diagnosis of brain tumors is made by clinical neurological examination as well as imaging (CT scan and/or MRI). The diagnosis of epilepsy is established according to the criteria of ILAE (International League against Epilepsy) in 1989, while epileptic Seizures are classified according to the classification of ILAE, in 2010. Results: Out of 805 (11.8%) with epilepsy in the study we have included 110 (13.7%) who were with partial epilepsy and fulfilled the foreseen inclusion criteria. From 110 patients included, tumors were the cause of epilepsy in 17 (15.5%) patients. Of these patients, 12 (70.6%) patients had epilepsy due to benign tumors, and other five (29.4%) patients had epilepsy as a result of malignant tumors. In cases with benign tumors, gliosis around epileptic focus was present in 9 (75%) patients, while in 3 (25%) patients gliosis was not present. In all 5 (100%) cases with malignant tumors, gliosis around epileptic focus was not present. Conclusion: Tumors represent frequent cause of symptomatic epilepsies, with about 15.5% of cases from the total number of epilepsies. The benign tumors were more epileptogenic compared with malignant tumors. The presence of gliosis around the tumor or epileptigenic foci is responsible for the generation of epileptic seizures and is seen in 75% of cases with slow-growing tumors.
    Healthmed 11/2014; Volume 8(Number 12):1291. · 0.44 Impact Factor

Full-text (2 Sources)

Available from
May 23, 2014