Runner’s gastrointestinal problems linked to anxiety, says study
Most runners will, at some point during their training routines or actual races, experience one or more gastrointestinal (GI) issues. The frequency tends to increase with the intensity of running – longer and harder runs result in a higher prevalence of GI issues. Although past research has attempted to identify the causes of exercise-related GI problems, most of these analyses have focused on the physiological causes.
A recent study published in the Journal of Sports Sciences in December 2017 suggested a direct link between runners’ GI problems and the levels of stress and anxiety in their daily lives. The study observed 150 runners – 74 men and 76 women – aged between 18 and 65 years. The participants maintained detailed records of their running activity, GI problems during their runs, and perceived levels of stress and anxiety measured via the Perceived Stress Scale (PSS) and Beck Anxiety Inventory (BAI) for 30 days.
The level of GI distress for each run was rated on a scale of 0 to 10, with “no discomfort” rated 0 and “severe discomfort” rated 10. Participants reported at least one symptom of GI trouble (including runner’s diarrhea, cramps, flatulence and acid reflux) at a rating of 3 or more on 45 percent of their runs. Runners with higher levels of stress and anxiety showed a higher prevalence of GI symptoms. In addition, higher intensity running was associated with a higher likelihood of GI distress, substantiating earlier research findings.
Everyday stress and anxiety, not running stress, causes GI problems
Besides stress and anxiety, the researchers investigated other contributing factors like the use of probiotics, caffeine and medication, including antibiotics and pain medication. The study also took into account the weight and height of the participants. Despite controlling these factors, a strong correlation was found between running-related GI problems and stress and anxiety. Runners were usually instructed to avoid pre-run consumption of caffeine and high-fat foods to prevent runner’s diarrhea. These findings reiterated that if anxiety levels were high, altering dietary patterns might not make a significant impact.
A striking feature of the study was that the participants were not stressed about an upcoming race or bettering their previous record. Both the PSS and BAI measure stress and anxiety based on people’s recollections of symptoms in their daily lives, not on a particular event or activity. However, this does not mean that pre-run stress and anxiety, diet and other factors were not affecting the digestive system.
According to study author Patrick B. Wilson, an assistant professor at the Old Dominion University in Norfolk, Virginia, if athletes suffered from GI problems before other stressful events like an interview or a public speech, it is likely that their running-related GI symptoms were due to stress and anxiety. Digestive problems may be caused by several factors, and it is necessary to use a process of elimination to identify the specific causes. “One way to narrow down the list of causes is to document when, and under what circumstances, the symptoms occur,” he said.
Managing everyday stress and anxiety levels
While runner’s diarrhea and other GI issues may cause immense discomfort, they are not reasons to give up running. Everyday stress can be lowered through self-care practices like yoga, deep breathing and meditation. However, if the symptoms are more anxiety-related, it may become important to seek professional help and undergo psychotherapy including cognitive behavioral therapy (CBT).
Anxiety disorders are the most common mental illnesses, affecting 40 million adults aged 18 or older (18.1 percent of the age group) in the United States. Although anxiety disorders can be treated, only 36.9 percent of those affected receive treatment. Many individuals with an anxiety disorder might also be suffering from co-occurring disorders, which can worsen their symptoms and impair recovery.
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