The Impact of Anxiety on GI Symptoms
by Doug Stewart
Pre-race nerves are likely something that many of you have experienced, along with the long wait for the loos on race day. There are varying factors that may influence this, and there is certainly evidence of a link between anxiety and gastrointestinal (GI) issues.
For example, one paper exploring ultrarunners in a 56km race discovered that those with higher levels of stress and anxiety in the three days leading into the race and on race morning had higher incidences of GI issues. Higher levels of anxiety in the 24 hours prior to race start were the strongest indicator (of those measured) for GI issues.
Another paper looked at triathletes and duathletes and the link between GI issues and sleep. It was discovered that chronic sleep dysfunction had a moderate link to GI symptoms, although the authors acknowledge that they do not know what role anxiety played in this.
What is evident from the research on endurance athletes and GI issues, is that the incidence of these problems is not purely linked to the food you are eating, or to how you are fuelling your race. Other variables clearly have a part to play.
A recently published paper explored the role of anxiety in creating GI symptoms, in relation to nutrition intake, both before and during a race. 149 runners (86 female and 63 male), primarily recreational athletes, were included in the research. Their food intake was logged, including things like caffeine, for the 4 hours prior to the race and during their races as well. Levels of anxiety were also tracked, allowing the researchers to compare nutrition intake around the competition and determine if levels of anxiety influenced this.
Overall, the findings suggested that higher levels of anxiety did not impact nutritional intake, in that varying levels of food and fluid taken prior to or during the race did not seem to be impacted by how anxious the runners felt.
If you experience pre-race anxiety, it is important to acknowledge how this could create potential GI symptoms. Whilst it appears that higher anxiety did not impact nutritional intake in recreational runners, it is well documented that it does impact GI. This is why you should have strategies aimed at reducing anxiety, in particular in the final 24 hours prior to the race. The Athlete's Gut by Dr Patrick Wilson is a great resource for those looking for more details (he was the lead author on two of the papers in the newsletter).
References:
Urwin, C.S., Main, L.C., Mikocka-Walus, A., Skvarc, D.R., Roberts, S.S., Condo, D., Carr, A.J., Convit, L., Jardine, W., Rahman, S.S. and Snipe, R.M., 2021. The relationship between psychological stress and anxiety with gastrointestinal symptoms before and during a 56 km ultramarathon running race. Sports Medicine-Open, 7(1), pp.1-11.
Wilson, P.B., 2020. Associations between sleep and in-race gastrointestinal symptoms: an observational study of running and triathlon race competitors. Sleep Science, 13(4), p.293.
Wilson, P.B., Ferguson, B.K., Mavins, M. and Ehlert, A.M., 2023. Anxiety and visceral sensitivity relate to gastrointestinal symptoms in runners but not pre-or during-event nutrition intake. The Journal of Sports Medicine and Physical Fitness.