Department of Family Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
Phys Sportsmed. 2009 Apr;37(1):54-63. doi: 10.3810/psm.2009.04.1683.
Sports medicine clinicians may encounter a wide variety of activity-related gastrointestinal (GI) disorders. The advancing ages and burgeoning obesity rates of the US population have generally increased the prevalence of GI conditions among adults. However, conditioned younger athletes with normal body mass indices also may experience disquieting activity-related GI disorders. While often mild and transient, some of these GI conditions may disrupt exercise routines or pose significant health risks to affected individuals. Gastroesophageal reflux occurs frequently during physical activity and should be empirically treated with activity reduction and dietary modifications in conjunction with antisecretory agents. Persistent or worrisome symptoms merit upper endoscopy, a thorough evaluation for non-GI causes and, rarely, surgery. Altered GI motility commonly occurs during vigorous activities that use dynamic or fluctuating body positions. Dietary and exercise modifications are usually enough to resolve these symptoms. Physical activity may also precipitate GI bleeding from upper and/or lower sources. Although mild or occult bleeding is most common, significant bleeding merits a thorough diagnostic evaluation after stabilization and treatment. Adequate hydration and gradual exercise progression may be particularly helpful to prevent the recurrence of bleeding. The judicious use of medications in conjunction with nonsteroidal anti-inflammatory drug avoidance may also be necessary. Fortunately, most activity-related GI disorders are self-limited and can be managed conservatively. After a brief period of modified activity, clinically stable individuals may progress their activity levels as symptoms allow.
运动医学临床医生可能会遇到各种与活动相关的胃肠道（GI）疾病。美国人口老龄化和肥胖率的上升，通常会增加成年人的胃肠道疾病患病率。然而，具有正常体重指数的年轻运动员在进行训练时也可能会出现令人不适的与活动相关的胃肠道疾病。虽然这些胃肠道疾病通常是轻微和短暂的，但其中一些可能会打乱运动常规或对受影响的个人造成重大健康风险。胃食管反流在身体活动中经常发生，应通过减少活动和饮食调整，并结合抗分泌药物进行经验性治疗。持续性或令人担忧的症状需要进行上内窥镜检查，以彻底评估非胃肠道原因，极少数情况下还需要手术。剧烈活动中经常会出现胃肠道动力改变，这些活动使用动态或波动的体位。通过饮食和运动调整通常可以解决这些症状。身体活动也可能引发上消化道和/或下消化道出血。虽然轻度或隐匿性出血最为常见，但大量出血需要在稳定和治疗后进行彻底的诊断评估。适当的水化和逐渐增加运动强度可能特别有助于预防出血复发。谨慎使用药物并避免使用非甾体抗炎药也可能是必要的。幸运的是，大多数与活动相关的胃肠道疾病是自限性的，可以通过保守治疗来管理。在短暂的活动调整期后，临床稳定的患者可以根据症状允许的程度逐渐增加活动水平。
