Background Gastrointestinal symptoms are common in endurance athletes but the prevalence across other sports is unclear. Methods A scoping review of studies available on Medline and SportDiscus databases (until September 1, 2025) which reported the prevalence of GI symptoms in highly trained and elite athletes was conducted. Keywords were used to identify cross-sectional studies and exclude those exclusively on endurance sports (distance running, cycling, triathlons). Articles were screened for eligibility and data were extracted by independent reviewers. Prevalence was reported according to timing, severity and sex. Results The search strategy generated 482 articles. After screening, seven studies were included with six different questionnaires utilised to determine prevalence. In total, there were 1087 athletes, of whom 682 were male and 405 female. Prevalence varied widely with 11.5-80.0% of athletes reporting at least one gastrointestinal symptom. The prevalence of any GI symptoms in males was 13.9-61% and females 20-80%. Three studies reported on timing of symptoms around training or competition, which ranged from 24.5-52.0% and this was more common in females (range 37.5-67.0%) than males (range 13.9-52.0%). Diarrhoea and urge to defecate were more common during exercise than at rest. Conclusion The prevalence of gastrointestinal symptoms in athletes varies widely, which may be due to heterogeneity in screening tools. There is a lack of studies discerning the severity and timing of symptoms, but it appears that around 1 in 2 female and 1 in 3 male athletes may experience gastrointestinal symptoms around competing. Future studies should aim to better standardise methods for assessing GI issues in athletes.
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