How to Relieve Exercise-Related Stomach Issues

As an active woman, you know there’s a not-so-glamorous side to living a fit lifestyle. From under-boob sweat to stinky sneakers, you’re a trooper when it comes to handling the awkward realities of working your butt off — including stomach issues, which many athletes experience on their quests for sculpted shoulders and tighter tushes.

From nausea, cramps and gas, to reflux, heartburn and bloating, as many as 50 percent of athletes experience exercise-related stomach problems, according to Nancy Clark, RD, a Boston-based sports nutritionist and author of Nancy Clark’s Sports Nutrition Guidebook. And, unlike sweaty clothes or those unexpected grunting noises your body lets out during a punishing set, gut issues can impact how you perform.

So what gives? Why do your cardio workouts sometimes turn into a sprint for the bathroom? It all comes down to physiological changes in your body as you train.

“During exercise, blood gets diverted away from your digestive system to your working muscles, as well as your skin to help you sweat,” explains Stephen Simons, MD, director of sports medicine and a physician at Saint Joseph Regional Medical Center in Mishawaka, Indiana. In other words, your muscles “steal” the blood flow away from your gastrointestinal (G.I.) tract, which relies on blood to aid digestion and keep your insides calm. With insufficient blood flow to your gut organs, it is harder for your digestive system to process food, turning the inner workings of your G.I. tract into Animal House: The Stomach Edition.

Sporting double X chromosomes also seems to put your belly at risk. “In general, women experience certain stomach issues, such as gas, bloating and irritable bowel syndrome at about 10 times the rate of men,” says J. Thomas Lamont, MD, a gastroenterologist at Beth Israel Deaconess Medical Center, and a professor at Harvard Medical School. While the reason isn’t fully understood, your period may be partly to blame. “Hormonal changes during the pre-menstrual phase can cause irritation in the gut,” he says — and a workout can cause symptoms to flare up even more in some women.

Unfortunately, as many as 29 percent of athletes say their G.I. issues impact their physical performance, reports a study in the International SportMed Journal. Of course, you’re not about to hang up your sweats to protect your belly — nor should you. Research shows that people who regularly exercise are less likely to experience symptoms of IBS and chronic constipation, and also reduce their risk of colon cancer by up to 40 percent. Happily, there’s plenty you can do to avoid exercise-related G.I. issues while continuing to push yourself in the gym, says Simons. The key is making small tweaks to your diet, as well as in your day and in your workouts. Here’s how to become a G.I. Jane in the gym, and in all your daily activities.

5 Ways to Ease Stomach Issues During a Training Session

How do you get through your training session without reaching for the Pepto?

1. Ease up.

“Stomach symptoms during exercise can be a sign that you’re doing too much too soon,” says Clark. “Just like your muscles have to adapt to a bigger load or increased activity, your digestive system has to learn to function with less blood flow during exercise.” A study in the Scandinavian Journal of Gastroenterology found that endurance athletes experienced significantly more transit issues (such as looser stools) during periods of heavy training compared to resting weeks. If you’ve recently started a new training program, take belly troubles into account, just like you would muscular issues. “If they’re interfering with your workout or your daily life, give your body more time to adapt and step things up in the gym more gradually,” Clark advises.

2. Breathe right.

While endurance athletes are more likely to suffer stomach issues that occur below the belt, weightlifters are far more susceptible to upper G.I. conditions, such as heartburn and acid reflux, reports a study in the journal Medicine & Science in Sports & Exercise. “If you’re lying on a bench lifting weights, you’re already at risk for reflux because reclining increases the likelihood of the gastric contents making their way into the esophagus,” says Lamont. Then, add pushing and grunting into the mix: “Many people have a tendency to bear down intensely with their abdomen in an effort to stabilize their body while lifting heavy weights,” says Simåons. “The increased pressure can be enough to push the stomach acid up into the esophagus, causing reflux.” Engage your core while lifting, but only as much as you need to without tensing the muscles so you can’t breathe. As a general rule, remember to gradually exhale on the positive phase of the lift (like when pushing the weights up in a bench press), which will reduce the likelihood of reflux.

3. Gulp – don’t sip.

Drinking water during exercise keeps tummy troubles at bay. Since blood is made up of nearly 50 percent water, less water means less blood, thereby limiting blood flow to your gut. Gulp your fluids, taking in enough water at a time to fill both cheeks, says sports dietitian Bob Seebohar, RD. “When you take little sips, the water is not emptied from the stomach as quickly, and you swallow air each time, which can cause bubbles that result in gas, cramps, bloating and pain.” It’s also easier to consume more water in gulps than in sips – and the more fluid you take in, the more easily those fluids travel through your G.I. tract instead of pooling in your stomach where they can cause cramps, says Seebohar.

4. Change it up.

About 71 percent of runners experience lower G.I. problems, such as cramps and bloating, which is more than is reported by cyclists. One reason: the up-and-down motion of running can cause the contents in your stomach to get pushed and jostled around, aggravating your digestive system and causing stomach issues, explains Simons. Instead of powering through the discomfort during a run, switch to a lower-impact activity, such as cycling, using the elliptical, rowing or lifting.

5 Ways to Focus On Nutrition

Your diet is one of the most important factors when it comes to digestion. Here’s how to eat for a healthy gut and a symptom-free workout:

1. Time it right.

Since your muscles steal blood away from your gut during exercise, you’re more likely to run into digestive distress if you’ve recently scarfed down some food. Ideally, give yourself three to four hours after a big meal before you work out to make sure the grub gets past your stomach and into the small intestine, says Simons.

2. Go light.

On days when you need to exercise within an hour of eating (such as before a morning workout or before a big race), Simons recommends avoiding foods that are digested more slowly, such as milk, butter, oatmeal, nuts and eggs. Instead, reach for eats that travel rapidly through your G.I. tract, such as a banana or a fruit smoothie (skip the protein powder, which delays digestion). Sticking to these foods can help stabilize your blood sugar and energize your session without competing with your muscles for blood flow.

3. Increase fiber incrementally.

A common complaint that people have when switching to a clean nutrition plan is increased gas and bloating. But this doesn’t mean that you should give up on clean eating. The likely culprit for these stomach issues: a huge increase in fiber, found in whole grains, beans, fruits and veggies. Fiber can be particularly stressful for the gut because it’s fairly indigestible, so when the body isn’t used to you eating so much fiber, it has to figure out how to pass it through without breaking it down, explains Seebohar. “Aim to increase your fiber intake by no more than five grams per week in order to allow your body time to adapt, so you avoid suffering symptoms along the way.”

4. Be pro probiotics.

As an active woman, you’ve likely noticed that the longer it takes for things to move through your G.I. tract, the more uncomfortable moving around can be (hello bloat!). In one study, high doses of probiotics – healthy bacteria added to some fermented foods such as yogurt and kefir – reduced the amount of time it took for food to move from entry to exit by about 33 percent, and study participants taking doses nearly 10 times lower than the high-dose group still reduced their digestion time by 24 percent. However, all participants who consumed probiotics were significantly less likely to report abdominal pain, nausea, constipation, irregular bowel movements and gas.

“Probiotics exist naturally in the gut to aid digestion, and consuming them in foods helps maintain that delicate balance,” explains Seebohar. He recommends downing one serving daily of either yogurt or kefir (make sure that it says “contains live active cultures” on the package).

See Also: 6 Best Probiotics For Your Health

5. Avoid faux fiber.

In one study, women who consumed snacks containing added fibers, such as inulin, oligofructose and resistant wheat starch, were up to 2.5 times more likely to experience gas and bloating than women who consumed bars without added fiber, reports the Journal of the Academy of Nutrition and Dietetics. (Interestingly, the women who consumed the added fiber did not feel more full or consume less food later in the day than those who ate the bars without the added fiber.) One reason for the digestive discomfort: foods that contain added fibers may provide far more of it than your body can process at one time – in the study, the bars packed at least 10 grams of fiber (by comparison, an apple contains just four grams). So if your tummy gives you grief, stick with whole foods, which are easier to digest and are less likely to cause you to O.D. In nutrition, just as in training, moderation is the key.

The Mind-Gut Connection

You’ve been there before. You’re standing behind a curtain waiting to take the stage, or you’re crouched at the starting line poised for the gun, when your tummy decides to take an Olympic-quality tumbling pass. You feel downright sick to your stomach and you’ve really got to go. Although your torso separates your brain from your belly, they’re actually more connected than you may think.

“Your brain is in constant communication with your gut via hormones, neurotransmitters and neuropeptides,” says Lamont. “When you feel stressed, chemicals from your brain target receptors in the gut that can result in cramps, gas and irritation,” he explains.The brain and gut are so intertwined, in fact, that Harvard researchers recently published a report titled “The Sensitive Gut,” in which they argue that the brain and the G.I. system are so closely linked that they should be regarded as one system, not two. They describe what they call the “brain-gut axis” — when stressed, your body is programmed to direct blood flow away from your digestive system to your muscles to fuel the fight or flight response. This means there is less blood flow to your gut organs, which can disrupt digestion and cause pain and other G.I. disorders.

Taking steps to reduce stress levels will help put the kibosh on the flood of neurochemicals causing your stomach symptoms. Taking deep breaths is one of the easiest ways to short-circuit the stress response by distracting your mind from what’s stressing you out. And as you slow your breath, your brain receives the all-clear message and pulls the brakes on the stress cycle.

How to Know When Stomach Issues Are Serious

Sometimes, a tender tummy isn’t your workout’s fault. Stomach issues can be a sign of something more serious.

“If your symptoms continue an hour or more after you’ve finished your workout, or occur on days when you don’t exercise, it could signal a more complex issue,” says Lamont. In addition to scheduling an appointment with your MD, keep a log of what you eat, along with the symptoms you experience so your doctor can connect the dots if certain foods are to blame.

Then, if you’re diagnosed with any of the issues below, keep these fit tips in mind. They’ll keep you feeling well while you and your doctor work to control the condition.

If You Have…	Try This Fit Tip
Celiac Disease	Develop a regular exercise routine. According to brand new research by Lamont and his colleagues, patients who are diagnosed with celiac disease and switch to a gluten-free diet tend to gain weight because their bodies are able to absorb nutrients more efficiently than they could before.
Irritable Bowel Syndrome (IBS)	Sip water throughout the day. People who have frequent diarrhea lose a lot of water through their stool, so they’re at a higher risk of dehydration, especially if they exercise.
Lactose Intolerance	Instead of shunning all dairy products (unless recommended by your doc), consume ones with probiotics, which can help to make dairy products more digestable.