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Area of Science:

  • Exercise Physiology
  • Gastroenterology
  • Sports Medicine

Background:

  • Long-distance running is associated with gastrointestinal (GI) distress.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used by runners.
  • The combined effects of exercise and NSAIDs on GI permeability are not fully understood.

Purpose of the Study:

  • To investigate the impact of prolonged exercise and NSAID ingestion on gastric and intestinal permeability.
  • To assess GI symptoms in runners following a marathon.
  • To differentiate the effects of ibuprofen versus aspirin on GI function during endurance events.

Main Methods:

  • 34 healthy marathon runners ingested a solution containing sucrose, lactulose, and rhamnose post-race.
  • Urinary excretion ratios of lactulose/rhamnose assessed small intestine permeability; sucrose excretion evaluated gastric function.
  • NSAID (aspirin or ibuprofen) ingestion was recorded, and GI symptoms were self-reported.

Main Results:

  • 75% of participants ingested NSAIDs (aspirin or ibuprofen).
  • Ibuprofen ingestion significantly increased urinary lactulose excretion and the lactulose/rhamnose ratio, indicating increased intestinal permeability.
  • Aspirin ingestion or no NSAID use did not significantly alter permeability markers compared to controls.
  • GI symptoms were reported by 50% of NSAID users and 50% of non-users, but ibuprofen users had significantly higher symptom reporting.

Conclusions:

  • Ibuprofen ingestion during prolonged exercise, but not aspirin, may increase gastrointestinal permeability and contribute to GI symptoms in runners.
  • Prolonged endurance exercise itself can induce GI symptoms, independent of NSAID use.
  • Runners experiencing GI issues should consider the type of NSAID used and the impact of prolonged exercise.