Gastroesophageal reflux in runners. Characteristics and treatment

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 trials. 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 less than 0.05). Reflux episodes were usually associated with belching. Ranitidine, 300 mg administered orally 1 hour before running, significantly (P less than 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 less than 0.05).