Pathologie hépatogastroentérologique du sportif

Abstract

The development of sports practicing is a new fact. The increasing participation of people to popular sport events (marathons, cycling sports…) and the development of recent concepts (triathlon, nature raids…) have generated the occurrence of a digestive symptomatology considered as "new" and specifically related to the effort. It affects sportspeople of any level, from simple amateurs to high-level athletes. This entity was initially observed in extreme sports and endurance sports. Although reported as anecdotes (e.g. the death of Philipides in Athens in 490 B.C. due to a hypothetical heat stroke, or Derek Clayton, vomiting at the end of his marathon victory in Antwerp in 1969,) there are numerous examples that have been largely shown by the widespread live broadcasting of sport events (e.g. the hospitalization of the triathlete Mark Allen due to epigastria cramps in Hawaii in 1988, the withdrawal of Sevilla Oscar from competition for the same reasons in the sixteenth stage of the Tour de France 2002, the withdrawal of Pete Sampras and Mary Pierce at Roland Garros due to digestive disorders in 1997…). Despite the difficulty of evaluating the exact prevalence of these digestive disorders, it seems that they may affect up to a quarter of the participants in endurance sports. The symptoms are described according to the localization of the lesion (oesophagus, stomach, intestines), and the degree of severity (primarily hemorrhagic demonstrations such as melaena and bloody diarrhoea). Liver diseases should not be forgotten, primarily exertional heat strokes and viral hepatitis. At least a cause of substandard performances for the athlete (cause of withdrawal in 5 to 15% of the cases during competitions), gastrointestinal disorders can present criteria of seriousness and be life-threatening, necessitating therefore rapid medical management, with a frequency of hospitalization shown to be 0.1 %.