The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Gastrointestinal distress is common during a 161-km ultramarathon
Abstract
This study examined the incidence, severity, and timing of gastrointestinal (GI) symptoms in finishers and non-finishers of the 161-km Western States Endurance Run. A total of 272 runners (71.0% of starters) completed a post-race questionnaire that assessed the incidence and severity (none = 0, mild = 1, moderate = 2, severe = 3, very severe = 4) of 12 upper (reflux/heartburn, belching, stomach bloating, stomach cramps/pain, nausea, vomiting) and lower (intestinal cramps/pain, flatulence, side ache/stitch, urge to defecate, loose stool/diarrhoea, intestinal bleeding/bloody faeces) GI symptoms experienced during each of four race segments. GI symptoms were experienced by most runners (96.0%). Flatulence (65.9% frequency, mean value 1.0, s = 0.6 severity), belching (61.3% frequency, mean value 1.0, s = 0.6 severity), and nausea (60.3% frequency, mean value 1.0, s = 0.7 severity) were the most common symptoms. Among race finishers, 43.9% reported that GI symptoms affected their race performance, with nausea being the most common symptom (86.0%). Among race non-finishers, 35.6% reported that GI symptoms were a reason for dropping out of the race, with nausea being the most common symptom (90.5%). For both finishers and non-finishers, nausea was greatest during the most challenging and hottest part of the race. GI symptoms are very common during ultramarathon running, and in particular, nausea is the most common complaint for finishers and non-finishers.
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In the citing paper
“The results found highlight diarrhea as the GI disease that affects the highest number of endurance athletes, representing 16.4–59% of the total number of registered cases of GI problems [24,25,30,37,57].”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [30]
In the citing paper
“A high incidence of GI disorders during physical exercise can be observed among long-distance runners [30], duathletes and triathletes [24], cyclists [33,37], and athletes who participate in other sports modalities of long duration [5,25].”
From Nutrition-Related Adverse Outcomes in Endurance Sports Competitions: A Review of Incidence and Practical Recommendations (2020) · cites this paper as [30]
In the citing paper
“In a large cohort of males and females (n = 272) competing in the Western States Endurance Run (100 mile; 161 km), the majority of athletes (96%) experienced GI symptoms at some point during the race, particularly at the hottest and likely most challenging part of the course, with 44% indicating that GI issues negatively impacted race performance.”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [130]
In the citing paper
“Nausea was cited as the most common symptom likely to affect race strategy (reported in 60% of athletes) [130], perhaps due to the subsequent impact on the ability to ingest food and fluid.”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [130]
In the citing paper
“A conservative estimate is that 30–50% of athletes experience GI-related issues during ultra-marathon [128], although values of 70–80% have been reported [129, 130].”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [130]
In the citing paper
“In a large cohort of males and females (n = 272) competing in the Western States Endurance Run (100 mile; 161 km), the majority of athletes (96%) experienced GI symptoms at some point during the race, particularly at the hottest and likely most challenging part of the course, with 44% indicating that GI issues negatively impacted race performance.”
From International Society of Sports Nutrition Position Stand: nutritional considerations for single-stage ultra-marathon training and racing (2019) · cites this paper as [130]
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“0% of the runners in this study, which is higher than the 37–85% incidence previously reported at other 161-km ultramarathons (Baska et al., 1990; Glace et al., 2002; Hoffman & Fogard, 2011; Stuempfle et al., 2013).”
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Cited by
Sorted by citations
Costa, R. J. S., Snipe, R. M. J., Kitic, C. M., & Gibson, P. R. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14157 · Cited by 450
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Metadata
- Authors
- Stuempfle, K. J., & Hoffman, M. D.
- Affiliations
- Gettysburg College (US)
- University of California Davis Medical Center (US)
- Corresponding author
- Stuempfle, Kristin Jean
- ORCID
- Hoffman, Martin Dean
- Venue
- Journal of Sports Sciences
- Publisher
- Informa UK Limited
- Published
- 2015-02-26
- Volume
- 33
- Issue
- 17
- Pages
- 1814-1821
- ISSN
- 0264-0414 (ISSN-L)
- 1466-447X
- OpenAlex
- W2036018519
- Cited by
- 137
- References
- 24
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 7 · 2023: 10 · 2022: 13 · 2021: 16 · 2020: 8 · 2019: 17 · 2018: 13 · 2017: 10 · 2016: 11 · 2015: 5
- FWCI
- 9.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Sports Sciences (publishedVersion)
- PubMed (publishedVersion)
- The Cupola: Scholarship at Gettysburg College (Gettysburg College) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- gastrointestinal symptoms, ultramarathon, nausea, flatulence, belching, diarrhea, race performance, heat exposure, endurance running
- MeSH terms
- Adult, Eructation, Female, Flatulence, Gastrointestinal Diseases, Humans, Male, Middle Aged, Nausea, Physical Endurance, Running
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