Exercise - related transient abdominal pain (ETAP)

• exercise-related transient abdominal pain (ETAP), often referred to as ‘stitch’, is a commonly experienced ailment that can be debilitating to exercise performance. In spite of its common occurrence, the condition has attracted little research attention and the aetiology of the pain remains unclear
  • explanations in the scientific literature for ETAP have traditionally centred on respiratory muscle hypoxia, stress on the ligaments that support the viscera, and, irritation of the parietal peritoneum
  • several characteristics of ETAP are consistent with muscular cramping and many anecdotal reports attribute the pain to abdominal or respiratory muscle spasm (cramp) - however a small study concluded that ETAP is not associated with elevated EMG activity, suggesting that the pain is not the result of muscle cramping (1)
    • in the opinion of the study authors, irritation of the parietal peritoneum best explains the established features of ETAP, including its:
      • relation to movement and the post-prandial state;
      • well-localised nature while occurring in any region of the abdomen and ;
      • mostly sharp or stabbing pain characteristics and;
      • and association with shoulder tip pain

Reference:

• (1) Morton DP, Callister R. EMG activity is not elevated during exercise-related transient abdominal pain.J Sci Med Sport. 2007 Aug 17.