‘Uncomfortable and Embarrassed’: The Stigma of Gastrointestinal Symptoms as a Barrier to Accessing Care and Support for Collegiate Athletes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Recruitment
2.2. Data Collection
2.2.1. Questionnaire
2.2.2. Interviews
2.3. Data Analysis
3. Results
3.1. Survey Findings
3.2. Interview Findings
3.2.1. GIS and ExGIS in Female Runners
3.2.2. The Stigma of ExGIS
3.2.3. Sport and Exercise Experiences of ExGIS
3.2.4. ExGIS Contributing Factors
3.2.5. Seeking Support for ExGIS
4. Discussion
4.1. Sex Differences in ExGIS
4.2. ExGIS Contributors
4.3. ExGIS Resources and Self-Management
4.4. Limitations and Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | All Participants (n = 96) | Females (n = 73) | Males (n = 23) | p-Value |
---|---|---|---|---|
Age in years, mean (SD) | 19.1 (3.9) | 19.0 (3.9) | 19.2 (3.7) | 0.96 |
Body mass index, mean (SD) | 20.7 (3.0) | 20.3 * (2.9) | 22.1 (2.7) | 0.004 |
Primary sport, n (%) | ||||
Varsity | 52 (53) | 39 (54) | 12 (52) | 0.22 |
Club | 44 (46) | 33 (46) | 11(48) | |
Perceived health, n (%) | ||||
Excellent or very good | 68 (71) | 50 (69) | 18 (78) | 0.68 |
Good | 24 (25) | 20 (27) | 4 (18) | |
Fair or poor | 4 (4) | 3 (4) | 1 (4) | |
Perceived food allergy, n (%) | 3 (3) | 1 (1) | 2 (9) | 0.14 |
Perceived food intolerance, n (%) | 21 (22) | 20 * (27) | 1 (5) | 0.02 |
Quantitative Survey Results (n = 96) | Qualitative Follow-Up Explaining Quantitative Results (n = 4) | Integration |
---|---|---|
Female athletes had higher occurrence of GIS at rest (60%) and during training (37%) than males (22%, 9%, respectively; p < 0.01) and were more likely to report food intolerance. Female athletes also perceived higher occurrence of specific upper and lower GIS during exercise than males (p < 0.05). GIS interruptions to exercise were most commonly by runners and team sport athletes (e.g., rugby, hockey). | Those interviewed were female runners despite an active and long period of recruitment across 11 different sports. | Female runners accept ExGIS as a normal and/or expected part of running culture, possibly limiting their perceptions of seeing it as a problem. The stigma of ExGIS may hinder interview recruitment and openness to seek support. Sex differences in ExGIS require further research. |
Type of exercise, dietary factors, and stress or anxiety were implicated in ExGIS. A total of 15.6% of athletes reported that sport nutrition products (mainly nutrition bars) contributed to ExGIS, while 36.5% were unsure of a possible link with these products. | Events of long duration, high intensity, and/or pre-event anxiety contributed to ExGIS. Athletes indicated using “trial and error” with diet (restriction) and hydration to manage unpredictable symptoms. | Athletes continually managed ExGIS through dietary modification with inconsistent results. University-tier athletes may lack awareness of and/or access to sport medicine and sport dietetic professionals to diagnose and manage ExGIS effectively. |
Top sources of nutrition information cited were dietitians and coaches. Sources of information used most frequently for ExGIS included family, friends or none. Only 12.6% of respondents sought medical guidance for ExGIS. | Athletes indicated that resources specific to ExGIS were unavailable, that they were unsure where to go for support, or that ExGIS was a normal occurrence for runners. Athletes had not sought advice from a medical professional outside of their family. Athletes used family, friends, teammates, the internet for support, though most felt the strategies they found were unhelpful. | Limited understanding of ExGIS in combination with uncertainty in finding accessible and effective resources may have led to less support seeking behaviours. Athletes with GIS at rest, in particular, should be referred for medical evaluation. |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Jamieson, J.A.; Olynyk, C.; Harvie, R.; O’Brien, S. ‘Uncomfortable and Embarrassed’: The Stigma of Gastrointestinal Symptoms as a Barrier to Accessing Care and Support for Collegiate Athletes. Dietetics 2025, 4, 11. https://doi.org/10.3390/dietetics4010011
Jamieson JA, Olynyk C, Harvie R, O’Brien S. ‘Uncomfortable and Embarrassed’: The Stigma of Gastrointestinal Symptoms as a Barrier to Accessing Care and Support for Collegiate Athletes. Dietetics. 2025; 4(1):11. https://doi.org/10.3390/dietetics4010011
Chicago/Turabian StyleJamieson, Jennifer A., Cayla Olynyk, Ruth Harvie, and Sarah O’Brien. 2025. "‘Uncomfortable and Embarrassed’: The Stigma of Gastrointestinal Symptoms as a Barrier to Accessing Care and Support for Collegiate Athletes" Dietetics 4, no. 1: 11. https://doi.org/10.3390/dietetics4010011
APA StyleJamieson, J. A., Olynyk, C., Harvie, R., & O’Brien, S. (2025). ‘Uncomfortable and Embarrassed’: The Stigma of Gastrointestinal Symptoms as a Barrier to Accessing Care and Support for Collegiate Athletes. Dietetics, 4(1), 11. https://doi.org/10.3390/dietetics4010011