CYCLING PERFORMANCE TIPS
Last updated: 12/06/2009
The Athlete and the GI Tract
Strategies to Minimize Gastrointestinal Symptoms with Exercise
Based on our understanding of normal gastrointestinal physiology as well as the effects of
exercise on the GI system, there are a number of strategies which might be expected
to minimize GI symptoms with exercise.
If this is a patient, coming to you for your professional opinion, don't forget
If preexisting/positive hemoccults or iron deficiency, they need an evaluation.
Especially so if an older, recreational athlete. Chest pain is more problematic.
- preexisting symptoms?
- review training program
- review diet - both between and during the activity; diet supplements
- and the physical exam
- especially stool hemoccults
- iron status
Other strategies, once specific diseases have been eliminated:
- Adequate training - As the athlete often has had a rapid incrase in his/her
training rpogram as the etiology, decreasing the intensity of workouts followed by a
gradual return (10% increase per week) to previous levels after symptoms resolve can be
a successful strategy.
- Consider changing the type of exercise or cross training if possible - for
example more cycling which is less jarring than running.
- Attention to hydration - Drink while exercising to minimize dehydration which
has a major effect on multiple GI symptoms. But limit intake to 600 - 1000 ml/hr. This is
a balancing act as we know that symptoms are increased with dehydration, and we also
know that symptoms can be increased with any oral intake. Recommendations will depends
on length of the event, level of intensity, ambient temperatures, and so on.
Small volumes are frequently better than larger, less often.
- Avoid hypertonic solutions - Preferably no more than 500 mosm, 6 to 8% simple
CHO; consider complex carbs solutions with lower osmotic activity to minimize gastric
distention, aggravate reflux, and help maintain oral fluid and Caloric replacement.
- Addition of NaCl to fluids for palatability (no effect on absorption)
- Consider the addition of CHO to oral fluids during exercise
- may theoretically increase fluid absorption in SB
- may blunt decreases in visceral blood flow based on experimental studies
- does provide Calories for competition lasting > 2 hours
- Avoid dramatic diet changes from a pre competition training diet.
- Don't eat a large meal of any type within 3 to 4 hours of exercising.
- Focus on a CHO rich diet pre exercise. Limit fat and protein pre
competition because of GI intolerance.
- Avoid a high fiber diet 3 days pre exercise because of it's impact on lower
- Avoid caffeine, vitamin C, and dubious ergogenic aids - all of which have been
associated with an increase in GI symptoms.
- Minimize the use of anti inflammatories.
- Consider a GI evaluation if there are recurrent symptoms in
the non exercising state.
- Prophylactic Medications - antimotility agents for diarrhea; H2 antagonist or
omeprazole if reflux or gastritis symptoms (especially for marathon and ultramarathon
Questions on content or
suggestions to improve this page are
Cycling Performance Tips
Table of Contents