Abstract
Background/Objectives: Sport-related concussion (SRC) elicits multi-systemic symptoms, including nausea, fatigue, and cognitive changes. Gastrointestinal (GI) symptoms are not well captured in current concussion assessments and may be under-recognised in clinical follow-up. GI disturbances may influence intake tolerance and day-to-day fuelling during post-SRC recovery. This study investigated the prevalence and severity of self-reported GI symptoms in Irish athletes after their most recent SRC, examined sex-based patterns, and evaluated the rationale for integrating GI symptom checks into standard concussion tools (e.g., SCAT6) and post-injury monitoring. Methods: An online survey was completed by recreational, competitive, and elite athletes who retrospectively self-reported concussion history, GI symptoms, and bowel function post-SRC and at the time of survey completion (ToSC; 0.03-216 months post-injury). The survey used the Bristol Stool Chart, Rivermead Post-Concussion Symptoms Questionnaire, and validated GI symptom measures. Descriptive statistics and chi-square tests examined timepoint- and sex-based differences. Results: A total of 106 athletes participated (55.7% female; mean age 26.4 ± 7.7 years), of whom 90.6% reported ≥1 GI symptom post-SRC, with greater severity observed for appetite loss, bloating, and abdominal discomfort. Bowel habits shifted bidirectionally for 42.5%, and 26.4% were experiencing ongoing symptoms at ToSC. Conclusions: Self-reported GI symptoms were common and appear under-recognised post-SRC. These findings support greater attention to GI symptom assessment and suggest that brief GI checks and facilitated access to nutrition advice where symptoms persist may be feasible within multidisciplinary, athlete-centred care. Prospective studies are needed to determine clinical relevance and to evaluate nutrition-related strategies.