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Objective evaluation of small bowel and colonic transit time using pH telemetry in athletes with gastrointestinal symptoms

¹ Department of Sports Medicine, Queen Mary and Westfield College, London E1, UK
² Wingate Institute, Barts and London School of Medicine, London E1, UK

Correspondence to:
Correspondence to:
Dr K Arjun Rao
Specialist Sportscare WA, Sports Medicine, 220 Whatley Crescent, Maylands, WA 6051, Australia; a.rao{at}bigpond.net.au

Background: Gastrointestinal (GI) disturbances are often reported by long distance runners and are more common in women, particularly after prolonged high intensity exercise.

Objectives: To determine whether these symptoms could be associated with alterations in GI motility.

Methods: Small bowel and colonic transit were measured using pH telemetry in a group of 11 female athletes (age 22 to 53 years), six of whom experienced lower GI symptoms during exercise. Subjects participated in two experimental sessions: a control measurement, where small bowel transit was estimated during a rest period (R) of six hours; and an exercise session (E), where small bowel transit was measured during a one hour period of high intensity exercise (cross country running) at >70% V^·O₂max. Colonic transit was estimated indirectly from determinations of whole gut transit time by radio-opaque marker.

Results: Small bowel transit time was 3.5 to 10.6 h (R) and 3.0 to 8.7 h (E) in asymptomatic athletes, versus 4.0 to 6.6 h (R) and 4.6 to 7.3 h (E) in symptomatic athletes (NS). Colonic transit time was 35.0 to 62.5 h (R) and 30.5 to 70.9 h (E) in asymptomatic athletes versus 20.4 to 42.9 h (R) and 21.5 to 67.2 h (E) in symptomatic athletes (NS).

Conclusions: Small bowel and colonic transit times were similar in the two groups in the rest and exercise sessions. The diarrhoea seen in this study did not result from accelerated colonic transit. Other mechanisms must be sought.

Abbreviations: MATT, mouth to anus transit time; MMC, migrating myoelectric complex; RTC, radio-telemetry capsule; V^·O₂max, maximum oxygen consumption

Keywords: colonic transit; small bowel transit; GI motility; athlete

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