Definition
Gastro-oesophageal reflux disease (GORD) in runners refers to the backflow of acidic stomach contents into the oesophagus during or after running. It typically presents as a burning sensation behind the breastbone, an acid taste in the mouth or regurgitation.
Physiologically, reflux corresponds to the passage of gastric contents through the lower oesophageal sphincter, which normally acts as a valve preventing acid reflux. When this barrier becomes less effective, stomach acid can irritate the lining of the oesophagus. Although often benign, this phenomenon can hinder the runner’s performance and digestive comfort, particularly during intense sessions or long races such as the marathon.
Anatomy
The lower oesophageal sphincter is a ring of muscle located at the junction between the oesophagus and the stomach. It relaxes to let food through, then closes again to prevent acidic stomach contents from flowing back up into the oesophagus.
In runners, several exercise-related stresses can disrupt the functioning of this barrier: the repeated vertical impacts of running increase intra-abdominal pressure, while slight trunk flexion during the stride accentuates the pressure exerted on the stomach. Both mechanisms promote the passage of gastric contents through the sphincter.
Epidemiology
Digestive problems, including gastro-oesophageal reflux, are relatively common in endurance sports. They affect occasional runners and experienced athletes alike, and occur more readily during intense sessions, long runs or races such as marathons or trail races.
Causes & risk factors
Exercise-related factors
During running, blood flow is redirected towards the working muscles, which slows digestion and can promote digestive problems. Repeated impacts increase intra-abdominal pressure, and the slightly forward-flexed trunk position accentuates the pressure exerted on the stomach.
Dietary and contextual factors
Certain factors increase the risk of reflux in runners: a meal too close to the session, fatty or spicy foods, coffee or energy drinks, fizzy drinks, competition stress and intense training. Long distances such as the marathon or trail running can accentuate these digestive problems.
Symptoms
Reflux can present during or after running as a burning sensation behind the breastbone, acid rising into the throat, an acid or bitter taste in the mouth, regurgitation, or a cough or throat irritation. These symptoms often appear during intense sessions, long runs or after a meal eaten too close to training.
When to see a doctor?
A medical consultation is recommended if heartburn is frequent, if symptoms persist outside running, if there is difficulty swallowing, or if significant chest pain develops. Treatment or further tests may be offered if chronic reflux is suspected.
Treatment
Adjust the interval between meals and running
It is generally recommended to wait 2 to 3 hours after a full meal before running. A light snack may be tolerated about an hour before exercise.
Choose well-tolerated foods
Before running, it is best to favour low-fat foods, easily digestible meals and moderate portions.
Test your diet in training
As with competition nutrition strategy, foods eaten before running should be tested during training rather than tried for the first time on race day.
Adjust the intensity of exercise
Very intense sessions can accentuate abdominal pressure and promote reflux; adjusting intensity during at-risk periods can help limit symptoms.
Prevention
Preventing reflux in runners relies above all on adjusting the timing and content of meals before exercise: favour light, low-fat meals already tested in training, allowing 2 to 3 hours before running. Limiting coffee, fizzy drinks and fatty or spicy foods before a session can also reduce the risk of symptoms.
Frequently asked questions
Can you run with gastro-oesophageal reflux?
Which foods should you avoid before running?
Is reflux common in runners?
Key points — Institut Basque du Coureur
Gastro-oesophageal reflux in runners is a relatively common digestive problem when running. It is often promoted by repeated impacts, pre-exercise eating and the intensity of the session. Adjusting meal timing and choosing well-tolerated foods generally helps to limit these symptoms.