Gymnast Stomach Issues: Constipation, Nervous Stomach and When to Worry

Gymnast stomach issues are more common than most parents and coaches realize. Constipation, bloating, reflux, nausea and that “nervous stomach” before meets can all get in the way of fueling, training and recovery. And these issues can be devastating for a gymnast, causing a lot of anxiety and making it even harder to eat enough.

Let’s talk about the most common causes of GI issues in gymnasts, what helps, and the signs that mean it’s time to bring in her doctor or a dietitian.

By Christina Anderson MS, RDN, CSP, CSSD · Updated October 2026

Common causes of gymnast stomach issues

• Not eating enough or restrictive eating, which slows digestion
• Nervous stomach from competition nerves and anxiety
• Stool withholding, or avoiding the bathroom at school, the gym or while traveling
• Dehydration, especially during travel and long practices
• Medical conditions like celiac disease, Crohn’s disease or ulcerative colitis
• Iron supplements, which can cause constipation and an upset stomach

Underfueling and disordered eating

An often-overlooked cause of tummy troubles is disordered eating. These days, many eating disorders don’t fit the stereotypical picture of anorexia nervosa. Gymnasts often struggle with orthorexia, an obsession with “clean eating” that leads to not eating enough, or with binge eating, which provides very inconsistent amounts of “stool bulk” and leads to bowel irregularities. Abuse of diuretics or laxatives can also cause bowel issues.

Eating disorders can be hard to spot, but GI symptoms can be a major clue worth exploring with professionals. (See Signs Your Gymnast Is Struggling With Disordered Eating.)

Constipation in gymnasts

Constipation can happen for a lot of reasons, but restrictive eating and eating disorders can slow digestion (gastric emptying and motility). That slowed motility then causes early fullness and can cause or worsen reflux. When there isn’t enough food moving through the digestive system, the gut slows down and becomes “sluggish.”

It becomes a vicious cycle. She doesn’t want to eat more because she feels full or constipated, and she’s afraid more food will make it worse. Here’s the thing: the counterintuitive solution is MORE food at regular intervals, a gradual increase in fiber and enough fluid every day. The gut needs to “wake up” and remember how to handle a normal amount of food.

Stool withholding

Another common cause of constipation is “stool withholding,” or not using the bathroom when the urge is there. This is a big issue for school-age kids who don’t want to go at school or at the gym. Travel can also throw off normal bowel habits. I counsel my athletes to:

• Hydrate while traveling (air travel is especially dehydrating)
• Keep normal meals and snacks on the road
• Leave time to use the bathroom in the morning and evening

(More on fluids in Gymnast Hydration.)

Nervous stomach and competition nerves

For other gymnasts, “nervous stomach” is very real. It comes from over-stimulation of the sympathetic nervous system, and it’s often categorized as irritable bowel syndrome (IBS). The stomach and intestines are innervated by the enteric nervous system, often called the “second brain.” Feeling anxious or nervous can trigger the “fight or flight” response and cause nausea and urgent trips to the bathroom.

For these athletes, cognitive behavioral therapy with a trained, licensed therapist is very effective. Nutrition helps too: the gut is trainable, and practicing meet-day foods ahead of time makes a big difference. (See Nervous Stomach and Competition Nerves in Gymnasts and Gymnast Competition Nerves.)

Gymnast stomach issues before and during practice

Some gymnasts get cramps, nausea or reflux when they eat before practice. Usually the fix is the type and timing of food, not skipping it:

• Keep pre-practice snacks mostly carbs with a little protein and low fat and fiber, especially close to practice.
• Allow time to digest before intense conditioning.
• Sip fluids through practice instead of chugging a lot at once.
• Practice it. Like any skill, the gut adapts to eating around training.

(Ideas in What to Eat Before Gymnastics Practice.)

Celiac disease, Crohn’s and ulcerative colitis

Autoimmune GI diseases like celiac disease, Crohn’s disease and ulcerative colitis can cause unintended weight loss and nutrient deficiencies, and lead to malnutrition if undiagnosed or untreated.

Celiac disease is an immune response to gluten, a protein found in wheat. Crohn’s disease and ulcerative colitis are inflammatory bowel diseases (IBD). IBD often shows up in the teen and young adult years. Gymnasts diagnosed with these conditions should see their pediatric gastroenterologist regularly to monitor treatment, labs and, most importantly, growth.

Linear growth (height) can take a big hit when a gymnast is malnourished, especially with malabsorptive diseases like celiac disease. These athletes should be carefully monitored by a registered dietitian who specializes in pediatrics. Key nutrients like calcium, vitamin D, iron and magnesium can be malabsorbed and lead to low bone density and anemia, which increases the risk of fractures and injury. (More on gymnast bone health.)

Because supplements aren’t regulated by the FDA and specific amounts are needed to correct deficiencies, any supplement should be prescribed and monitored by her medical team. For a lot of these conditions, I see supplements and probiotics thrown at the athlete that are often ineffective, a waste of money and potentially contaminated.

Signs of gymnast stomach issues to watch for

• Pallor or fatigue. Iron deficiency anemia can make a gymnast look pale, but more often it shows up as fatigue and trouble recovering from training. Undiagnosed celiac disease or restrictive eating can both lead to anemia. Iron supplements can cause stomach upset and constipation, but newer dosing strategies cause less upset. Iron should be prescribed by a physician and monitored with labs. (Listen to Gymnast Iron Deficiency.)
• Lots of time in the bathroom. Sometimes athletes “go to the bathroom” to avoid a hard set. But don’t assume that’s it when she could be struggling with real GI issues. Talk to the athlete and parent privately. GI issues can be really embarrassing.
• Unexplained weight loss. Gymnasts sometimes “slim down” unintentionally from more training, a growth spurt or not eating enough. This hurts muscle development and training adaptations, and can disrupt hormones, slowing growth and stopping periods. Bring in a registered dietitian to assess her intake. When weight loss isn’t explained by what she’s eating, it can prompt testing for conditions like celiac disease or IBD.
• Upset stomach and missed practices. These can be tied to anxiety and should be addressed with a sports psychologist or licensed therapist. Gymnasts have a lot going on outside the gym that coaches never see. Talk privately with the athlete and parent, and have a network of professionals you can refer to.

Frequently asked questions

Get help for your gymnast

As a pediatric sports dietitian, my passion is helping athletes keep training and performing while managing GI issues and chronic conditions. Not sure if your gymnast’s stomach issues are tied to how she’s fueling? Start with our free masterclass or take the free Gymnast Fueling Quiz. And if you want more than a generic meal plan, The Balanced Gymnast® Program is our 1:1 program, built by a former gymnast, nationally rated NCAA/USAG judge and pediatric sports dietitian who lives and breathes this sport. We build her plan around HER: her training, her growth, her stomach and the foods she actually likes, so she can close the recovery gap each and every day.