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Gastroesophageal Reflux in Runners: Characteristics and Treatment

Barry B. Kraus, MD; Jane W. Sinclair, PA; and Donald O. Castell, MD
[+] Article and Author Information

Requests for Reprints: Donald O. Castell, MD, Division of Gastroenterology and Hepatology, Jefferson Medical College, 1025 Walnut Street, Philadelphia, PA 19107.

Current Author Addresses: Dr. Kraus: Department of Medicine, University of Florida Health Sciences Center, Gainesville, FL 32605. Ms. Sinclair: Bowman Gray School of Medicine, 300 South Hawthorne Road, Winston-Salem, NC 27103.

Dr. Castell: Jefferson Medical College, 1025 Walnut Street, Philadelphia, PA 19107.


©1990 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1990;112(6):429-433. doi:10.7326/0003-4819-76-3-112-6-429
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Study Objective: To test the potential of distance running to induce reflux in healthy subjects and the ability of ranitidine to decrease esophageal acid exposure.

Design: A randomized, single-blind, crossover study. Objective assessment of reflux was done using an ambulatory intra-esophageal pH monitor during both a baseline hour and 1 hour of running on 2 days of testing.

Subjects: Fourteen normal volunteers (10 men, four women) between 22 and 37 years of age were studied. All volunteers ran regularly, completing an average of 20 miles weekly for at least 6 months.

Interventions: Ranitidine, 300 mg orally, or an identical placebo was administered after a low-fat breakfast just before the baseline hour of pH recording.

Setting: Esophageal motility and pH probe placement was done in the gastroenterology unit at Bowman Gray Medical Center. Running was done on local jogging trails.

Measurements and Main Results: There was more gastroesophageal reflux during running than during the baseline hour when reflux was measured at a pH threshold of 3.0, 4.0, or 5.0 (P < 0.05). Reflux episodes were usually associated with belching. Ranitidine, 300 mg administered orally 1 hour before running, significantly (P < 0.05) reduced the amount of esophageal acid exposure during running.

Conclusions: Gastroesophageal reflux occurs during running in healthy volunteers. It is usually associated with belching. Acid suppression with ranitidine decreases intraesophageal acid exposure during running (P < 0.05).

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