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Does exertional heat stress impact gastrointestinal function and symptoms?

Published:October 15, 2022DOI:https://doi.org/10.1016/j.jsams.2022.10.008

      Abstract

      Objectives

      Exertional-heat stress generates a thermoregulatory strain that exacerbates splanchnic hypoperfusion and sympathetic drive, but the effects on gastrointestinal function are poorly defined. The study aimed to determine the effects of exertional-heat stress on gastric myoelectrical activity, orocecal transit time (OCTT), and gastrointestinal symptoms (GIS).

      Design

      Randomised cross-over study.

      Methods

      Endurance runners (n = 16) completed 2 h of running at 60 % O2max in 35 °C (HOT) and 22 °C (TEMP) ambient conditions. Surface electrogastrography (cEGG) was recorded pre- and post-exercise to determine gastric myoelectrical activity, a lactulose challenge was used to determine OCTT, and GIS were recorded using a modified visual analogue scale tool.

      Results

      Post-exercise Tre [HOT:38.8(38.5 to 39.0)°C and TEMP:38.1(37.8 to 38.4)°C] and Δ Tre [HOT:2.2(2.0 to 2.4)°C and TEMP:1.5(1.2 to 1.8)°C] was higher on HOT compared to TEMP (p < 0.001). Normal gastric myoelectrical cycle frequency reduced (p = 0.010) on HOT [−11.7(−20.8 to −2.6)%], but this decrease did not differ (p = 0.058) from TEMP [−2.7(−8.3 to 3.0)%]. Bradygastria increased post-exercise on both trials (HOT:11.3(2.3 to 20.4)%, p = 0.030; and TEMP:7.4(2.1 to 12.6)%, p = 0.009). OCTT did not differ between trials (p = 0.864) with transit response classified as very slow on both HOT (99(68 to 131)min) and TEMP (98(74 to 121)min). GIS incidence was higher on HOT (88 %) compared to TEMP (81 %), in accordance with greater total-GIS and upper-GIS severity (p = 0.005 and p = 0.033, respectively).

      Conclusions

      Running for 2 h at 60 % O2max in either hot or temperate ambient conditions instigates perturbations in myoelectrical activity and OCTT, with GIS incidence and severity greater in hot conditions.

      Keywords

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