Athletic Training & GERD

By Michelle Matte

The acronym GERD stands for gastro-esophageal reflux disease. GERD represents acid reflux at its extreme, causing damage to the esophagus and setting off a chain-reaction of symptoms, some of which are life-threatening. GERD is most commonly seen in folks over the age of 40. However, some young athletes suffer from exercise-related GERD. While the disorder is more common in athletes who do high-intensity anaerobic sports like weight lifting, endurance athletes are not immune. Recognizing symptoms in the early stages will enable athletes to implement aggressive measures to treat this disruptive condition.

Symptoms and Cause of GERD

Symptoms of GERD include, indigestion, regurgitation, erosion of tooth enamel, sleep apnea, hiccups, coughing attacks, difficulty swallowing, chronic sore throat and asthma. The culprit, digestive acid, manages to leak from the stomach through the lower esophageal sphincter and into the esophagus. The acid erodes esophageal tissue, which is not protected by a lining as is the stomach. When in a horizontal position, such as when sleeping or swimming, acid can move into the throat and mouth, and even into the lungs, causing these symptoms.

How Training Stimulates GERD

Because athletic performance often places stress on the abdomen, athletes who are anatomically predisposed to a leaky esophageal sphincter may experience some reflux during athletic activity. Eating a large meal before performance may exacerbate the problem. During physical activity, blood is shunted away from the digestive tract, allowing food to sit undigested for an extended period of time. During this time, the stomach produces more acid in an attempt to break down the meal, increasing reflux. Other suspected causes of reflux in athletes include excessive consumption of sports drinks, alcohol, anti-inflammatory analgesics and emotional stress.

Effect of GERD on Athletic Performance

Over 75 percent of people with asthma also have GERD. Athletes with GERD may experience shortness of breath due to asthma or diaphragmatic spasms. In sports that require maximum cardiorespiratory exertion, GERD can impede an athlete's performance. Early intervention to minimize acid reflux can spare lung tissue and prolong an athlete's career.

Nurtritional Considerations

Certain types of foods will cause the stomach to produce large amounts of acid. Unfortunately, many of these foods are a mainstay in the diets of young people. Greasy or spicy foods, foods which are naturally acidic like tomatoes and citrus, chocolate, peppermint, carbonated beverages, caffeine and alcohol all stimulate acid production. Protein and creatine supplements have also been cited. Athletes who suffer from GERD should minimize consumption of these foods during training season and before a competition. Staying hydrated will also diminish the effects of reflux during activity.

Other Interventions

In addition to nutritional changes, athletes predisposed to GERD should make behavioral modifications. Rather than eating two or three large meals, consume small meals throughout the day. Avoid eating right before a training session or competition. Stop eating two to three hours before going to sleep, and elevate the head of your bed a few inches to discourage reflux. Minimize the use of over-the-counter pain medications like ibuprofen or acetaminophen. If lifestyle modifications are not enough, pharmacological or surgical intervention may be called for.

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