Frequency of Chronic Gastrointestinal Distress in Runners: Validity and Reliability of a Retrospective Questionnaire
Abstract
Gastrointestinal (GI) symptoms may affect up to 90% of competitors during endurance races. Studies have typically assessed GI symptoms retrospectively or only over an acute timeframe, and information on the validity and reliability of the questionnaires employed is lacking. This investigation aimed to estimate the frequency of GI distress experienced by runners over 30 days and to establish the validity and reliability of a retrospective GI symptom questionnaire. Runners (70 men, 75 women) recorded GI symptoms with a prospective journal for 30 days. Retrospective GI symptom data were then collected after the 30-day period on two occasions within one week. GI symptoms were rated on a 0-10 scale. Descriptive statistics for GI symptoms are reported as medians (interquartile ranges) because of nonnormal distributions. Men and women experienced at least one GI symptom on 84.0% (59.8-95.1%) and 78.3% (50.0-95.2%) of runs, respectively. Moderate-to-severe GI symptoms (score of ≥5) were experienced on 13.8% (6.7-37.3%) and 21.7% (5.3-41.2%) of runs for men and women. Spearman's rho correlations between journal ratings and retrospective questionnaire ratings ranged from 0.47 to 0.82 (all p < .001), although they were highest when journal ratings were quantified as mean 30-day values (all rho ≥ 0.59). Reliability of the retrospective questionnaire ratings was high (rho = 0.78-0.92; p < .001). In comparison with tracking GI symptoms with a daily journal, retrospective questionnaires see…
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GIS scores from Likert scales are often right-skewed, yet most studies used parametric analytical approaches that may be inappropriate for non-normally distributed data from small sample sizes.
“For example, GIS scores from Likert scales are often right‐skewed (Wilson 2017), yet most studies used parametric analytical approaches that may be inappropriate for non‐normally distributed data from small sample sizes.”
From Gastrointestinal Symptoms Associated With Sodium Bicarbonate Supplementation Protocols: A Systematic Review (2026) · cites this paper as Wilson 2017
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Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations
de Oliveira, E. P., Burini, R. C., & Jeukendrup, A. (2014) · Sports Medicine · doi:10.1007/s40279-014-0153-2 · Cited by 402 · cited 3× · see citing works
“The large variation between studies may be due to methodological differences in quantifying GI symptoms, as well as variations in factors such as exercise modality, exercise intensity, exercise duration, environmental conditions, and nutritional intake (de Oliveira et al., 2014).”
BackgroundInfluentialNutritional Intake and Gastrointestinal Problems during Competitive Endurance Events
PFEIFFER, B., STELLINGWERFF, T., HODGSON, A. B., RANDELL, R., PÖTTGEN, K., RES, P., & JEUKENDRUP, A. E. (2012) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31822dc809 · Cited by 287 · see citing works
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Mohr, A. E., Pugh, J., O'Sullivan, O., Black, K., Townsend, J. R., Pyne, D. B., Wardenaar, F. C., West, N. P., Whisner, C. M., & McFarland, L. V. (2022) · Frontiers in Nutrition · doi:10.3389/fnut.2022.809983 · Cited by 27 · see citing works
Wilson, P. B. (2020) · Journal of Dietary Supplements · doi:10.1080/19390211.2018.1492484 · Cited by 15 · see citing works
Winter, I. P., Sarac, P., & Wilson, P. B. (2026) · European Journal of Sport Science · doi:10.1002/ejsc.70225
Self-citation
- Authors
- Wilson, P. B.
- Affiliations
- Old Dominion University (US)
- Corresponding author
- Wilson, Patrick B.
- ORCID
- Wilson, Patrick B.
- Venue
- International Journal of Sport Nutrition and Exercise Metabolism
- Publisher
- Human Kinetics
- Published
- 2017-08
- Volume
- 27
- Issue
- 4
- Pages
- 370-376
- ISSN
- 1526-484X (ISSN-L)
- 1543-2742
- OpenAlex
- W2593297191
- Cited by
- 35
- References
- 3
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 9 · 2020: 3 · 2019: 2 · 2018: 2
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Sport Nutrition and Exercise Metabolism (publishedVersion)
- PubMed (publishedVersion)
- ODU Digital Commons (Old Dominion University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- gastrointestinal distress, runners, endurance running, questionnaire validity, questionnaire reliability, sex differences
- MeSH terms
- Adult, Female, Gastrointestinal Diseases, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Retrospective Studies, Running, Reproducibility of Results
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