IBS in athletes is way more common than you think

After working with athletes struggling with IBS (Irritable Bowel Syndrome), I wanted to write a blog addressing this frustrating condition for this specific population. These cases tend to be more complicated than a typical IBS case because symptoms are commonly related to training and/or competing. This makes things particularly difficult because training and competing are part of an athlete’s regular routine. In order to break this loop, we have to regain balance throughout the digestive tract by taking a multi-faceted approach.

There are many athletes struggling silently with IBS symptoms and they are less likely to seek out medical support for IBS than the average population. One study showed that only 2.8% of athletes have been diagnosed with IBS, but nearly 10% would meet the diagnostic criteria [1].  It also showed that only 47% of athletes consulted with a medical professional about their symptoms. This is potentially attributed to athletes believing that there is nothing they can do about the digestive symptoms they experience during training and competing.

That same study showed that almost half of all athletes with digestive symptoms and 80% of those diagnosed with IBS have tried some type of over-the-counter medications to help reduce symptoms. There are several factors that contribute to IBS and digestive issues in athletes.

Multiple factors contribute to IBS:

Altered Digestive Motility: Training can lead to altered digestive motility. Digestive motility is the movement of food throughout the digestive tract and it can be altered by either increasing or decreasing the rate of that movement. The timing and composition of meals can affect this directly and result in gas, diarrhea, abdominal pain, cramping, or constipation.  With slower motility there will be less frequent bowel movements and constipation. With increased motility, there will be more frequent bowel movements and diarrhea/loose stool. Every person’s baseline motility varies and what’s most important is bringing things back into balance. Bouts of diarrhea leading up to a race or training is a classic hallmark of irregularly increased motility.  

Diet and Nutrition: Diet and nutrition choices, protein shakes, energy gels, and caffeine consumption can also trigger digestive symptoms, especially if someone is consuming foods they are intolerant/sensitive to. I can’t tell you how many times we’ve discovered a low-grade lactose intolerance or whey/casein sensitivity. Excessive caffeine consumption can also trigger IBS symptoms.

Gut microbiome shifts can occur at any time throughout life and lead to changes in digestive capacity and symptoms. Multiple rounds of antibiotics (even during childhood), periods of high stress, poor food choices, and even episodes of food poisoning can alter our gut microbiome substantially over a long period of time and lead to predisposition to or exacerbation of IBS.

Mental health: It’s no secret that mental health plays a huge role in digestive health. Our digestive tract is directly connected to our brain via the vagus nerve which controls many aspects of our digestion. Periods of high stress or anxiety shift our nervous system away from parasympathic (rest & digest) mode towards sympathetic (fight or flight) mode, which is detrimental to regular digestion.

Dehydration and electrolyte imbalances: We lose more than just water with diarrhea and loose stool. We also lose a ton of those crucial electrolytes that help our muscles respond to demand and maintain fluid balance in the body. Water is absorbed from food/drink throughout the entirety of our small and large intestine. With diarrhea and loose stool, this process is reduced due to the increased motility of the GI tract. Constipation can be triggered by too little water/electrolyte intake.

Fixing your digestion:

I wish I had a magic bullet supplement or diet change that worked for every person that I could list out here. The truth is every case and person is different. What’s most important is drilling down into the data to help understand what exactly is occurring with each individual IBS case. Once we have that information, we’re able to act on it and put together a strategy.

The first step is almost always to get some functional digestive testing done to determine what factors may be exacerbating the issue. Increased levels of dysbiotic bacteria, fungi, viruses or parasites are commonly discovered on testing. In addition, we also get information back on the overall functionality of the GI tract. How much inflammation is present? How reactive is the immune system? How well are fats, carbs, and proteins being digested and absorbed? What foods are being reacted to? All of these questions can be answered with testing and helps us put together the personalized approach we need to take.

Putting together a plan based on the test data and symptoms is how we find the route to long-term improvement. Testing is helpful, but it only tells us part of the story. Your actual symptoms and experience inform our decision making and direction with supplements, diet, and lifestyle changes.

Ready to get started?

A free 15-minute phone consult with me is the first step to fixing your IBS. During that call we will discuss your story, my approach to addressing your symptoms, and the root cause of IBS. Click here to book your consult and get started.

[1] Lauren A. Killian and Soo-Yeun Lee. 2019. Irritable bowel syndrome is underdiagnosed and ineffectively managed among endurance athletes. Applied Physiology, Nutrition, and Metabolism44(12): 1329-1338. https://doi.org/10.1139/apnm-2019-0261