Key Points and Treatment

• Gastroesophageal reflux can be worsened by exercise; treatment with dietary modifications and proton pump inhibitors is usually successful.

• Exercise-induced diarrhea is common in endurance sports; treatment focuses on dietary manipulation before competition and antidiarrheal medications such as loperamide in refractory cases.

• Gastrointestinal bleeding in athletes ranges from microscopic blood loss to ischemic hemorrhagic gastritis or colitis, but pathologic causes of bleeding should be ruled out.

Gastrointestinal problems are common in the general population and in exercising individuals. Although diagnosis and treatment for many of these issues are similar, exercise may make some issues worse or may present special treatment challenges. See online discussions for the following at

• Gastroesophageal reflux

• Exercise-induced diarrhea

• Gastrointestinal bleeding

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