Question from a Coach: GI Distress in an Athlete

I received a question from a coach about GI distress in a new athlete she was training. According to the athlete, stomach discomfort is sabotaging his running.  The athlete claims to have tried everything to prevent the GI distress.  The coach asked for a suggestion on how to start working with her client.

My response:

You are off to a good start in finding the issue by getting the background info.

The first thing to remember; don’t trust your client.  It is easy for our clients to believe because something happens once it will happen every time.  Have him connect you with the sports nutritionist.  Did the athlete try everything?  Question all beliefs.  Get the nutritionist’s thoughts.


  • Seven day food and fitness log.  If they are good with technology use the app myfitnesspal and you can friend them to see their food and exercise diary.  You want the client to record times they eat, what they eat, quantity of food and when they exercise. Log hydration too.
  • Track exercise intensity.
  • MD appointment to rule out common issues including irritable bowel syndrome. I suggest an MD with specific interest and experience in sports medicine.
  • Put a moratorium on sports nutrition.  Easier to rule out one thing at a time rather than change everything.

And since it is that time of year, I suggest each of your clients undergo the following blood tests.  Remember, a sports MD will know the “normal” ranges for endurance athletes.  Tests:

  • Lipid Panel (cholesterol)
  • Thyroid Panel
  • CBC (red/white blood cell panels)
  • Vitamin B
  • Vitamin D
  • Iron/ferritin panel
  • Bodpod or DEXA Scan for body composition profile
  • Testosterone (yes, even for women).

Some of the best in our sport still have GI issues.  Resolving GI issues starts with asking the right questions.  And a healthy dose of skepticism about the answers!

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