22/11/2025
The Athletes’ Gut Problem 🤸 5 Key Triggers + The Menstrual Cycle Factor
Your intestine is 7-9 metres long! The small intestine is roughly 6-7 metres and is highly folded to optimise nutrient absorption. The large interesting (colon) is about 1.5 metres long.
That’s a lot of tubing for something to go wrong and go wrong it does, especially for elite athletes who push their bodies to the limit.
Here are the reasons gut issues are common for athletes:
🧠 1. Reduced Blood Flow to the Gut
🍀 During exercise, especially endurance or high-intensity training, blood is redirected from the digestive system to working muscles and skin (for cooling). This can reduce intestinal oxygen by up to 80%, damaging the gut lining and impairing digestion and absorption. This, in turn, can:
🍀 Increase intestinal permeability, “leaky gut,” allowing bacteria and endotoxins to enter the blood system, triggering an immune response leading to inflammation and discomfort
🍀 The effect is greater in hot environments or with dehydration.
💧 2. Dehydration and Electrolyte Imbalance
🍀 Sweating and insufficient fluid replacement can concentrate the gut contents and alter motility (making food move through the gut faster or slower). Dehydration slows gastric emptying, and an electrolyte imbalance can cause nausea, cramping, and diarrhoea.
🍀 Sodium and potassium losses affect smooth muscle function in the intestines.
Athletes often under-replace fluids during long events, which can compound gut distress.
🍞 3. Nutrition Timing and Composition
Many athletes consume carbohydrate-rich gels, drinks, or bars during training or competition.
🍀 Excess simple sugars (especially fructose) and artificial sweeteners can draw water into the intestine, leading to diarrhoea or bloating.
🍀 Large pre-event meals, high-fibre, or high-fat foods slow digestion, which can cause reflux or cramps when combined with exertion.
Inadequate adaptation to fueling strategies, “training the gut,” also plays a role.
🦠 4. Microbiome Disruption
Regular heavy training can alter the gut microbiome balance (the trillions of microbial species in your gut):
🍀 Stress hormones, like cortisol, can affect gut motility and microbial diversity
🍀 Frequent antibiotic use or restricted diets can further disrupt microbial stability
🍀 Microbiome imbalance (dysbiosis) can contribute to inflammation, poor nutrient absorption and even mood disturbances (not helpful if you need to be performing at your peak).
🏃♂️ 5. Mechanical and Mental Stress
🍀 Repetitive jostling (like running or cycling) mechanically agitates the intestines. When combined with pre-competition anxiety, this triggers the gut–brain axis, increasing motility and urgency.
🍀 “Runner’s diarrhoea” and “exercise-induced nausea” are partly driven by sympathetic nervous system overactivation.
Menstrual effects on gut stability
Female athletes often experience additional gut challenges because the menstrual cycle influences digestion, inflammation, and gut motility:
🍀 In the luteal phase (the week or two before a period), rising progesterone slows digestion, which can lead to bloating, constipation and a heavier, more sluggish gut during training.
🍀 As hormone levels drop right before menstruation, many women experience a sudden increase in prostaglandins, which stimulates uterine contractions but can also increase gut motility, triggering diarrhoea, cramping, or nausea.
🍀 Low iron stores, more common in female endurance athletes, can worsen gut sensitivity and impair oxygen delivery to the intestinal lining, amplifying exercise-induced gut symptoms.
The result is that digestion feels different across the cycle, and certain training loads or nutrition strategies may be better tolerated at specific times.
Understanding these hormonal rhythms helps female athletes tailor fueling, hydration, and recovery strategies to minimise gut distress and improve performance.
🩺 How Athletes Can Mitigate Gut Issues
Train the gut: gradually introduce nutrition strategies during training to improve tolerance.
✅ Hydrate strategically: maintain electrolyte balance and monitor sweat losses.
Adapt diet: reduce high-FODMAP foods or artificial sweeteners before events.
Support gut-lining integrity: include glutamine (helps reduce leaky gut), probiotics (support a healthy microbiome), and polyphenol-rich foods to help protect the intestinal barrier.
✅ Manage stress: recovery, sleep, and breathing practices help modulate gut-brain signalling.