It happens. More than you would think.  Strenuous on court activity triggers cramping, bloating, gas and diarrhea. It’s not only embarrassing, but it can affect your tennis game. It’s not like you can just drop your racquet between points and head for the closest bathroom!!


The phenomenon, sometimes referred to as ‘runners’ trots’ occurs in 30-70% of endurance athletes. The cause is uncertain, but it could be a combination of the vibration of physical exercise, and shifts in blood flow from the intestines.  The tremendous long-term exertion associated with tennis makes it high risk for this side effect. Furthermore, these issues are more common in women.


But there is hope on the horizon.  Recent research in a group of 910 high performance athletes suggested a large majority intentionally restricted foods prior to high exertion activities1.  When the restricted foods were scrutinized, FODMAPS were present 78% of the time.  Another study used a low-FODMAP-diet program in an athlete to treat their exercise-induced GI symptoms, with success2 .


Never heard of a FODMAP?  Well, you are not alone.  FODMAP is an acronym for a group of carbohydrates that are difficult to digest and can lead to symptoms of digestive discomfort.  These include wheat, dairy, fructose, and inulin. What seems ironic, is many of these FODMAP offenders are added to energy bars and sports beverages. That fuel could be making your workout less efficient!


Limiting high-FODMAP foods may be the key to enhancing your game and avoiding the interruption and embarrassment of digestive discomfort. To find out more about the low-FODMAP diet, download a free low-FODMAP diet guide at


Be healthy and happy,


Rachel Pauls, MD


Dr. Pauls is an internationally renowned surgeon and researcher who has published more than 75 peer reviewed journal articles on a wide range of significant medical issues.



  1. Lis D, Ahuja KD, Stellingwerff T, et al. Food avoidance in athletes: FODMAP foods on the list. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2016:1-3.
  2. Lis DM, Ahuja KD, Stellingwerff T, et al. Case Study: Utilizing a Low FODMAP Diet to Combat Exercise-Induced Gastrointestinal Symptoms. International journal of sport nutrition and exercise metabolism. 2016.



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