Can You Get a Stitch From Not Drinking Enough Water?

November 30, 2025 •

4 min read

While the exact cause of a side stitch—medically known as exercise-related transient abdominal pain (ETAP)—is not fully understood, a lack of proper hydration is a widely cited contributing factor. Dehydration and electrolyte imbalances can contribute to muscle cramps, which may be perceived as a painful side stitch during physical activity.

Quick Summary

Dehydration can contribute to side stitches, or ETAP, due to its impact on muscle function and electrolyte balance. While other factors like breathing, posture, and pre-exercise meals play a role, inadequate hydration can lead to cramps that mimic the sensation of a stitch.

Key Points

Indirect Cause: Dehydration doesn't directly cause a stitch, but it contributes to the physiological conditions that make them more likely, such as muscle cramping and digestive issues.
Electrolyte Imbalance: Low levels of water and key electrolytes (like sodium and potassium) can cause muscles, including the diaphragm, to spasm and cramp, mimicking a side stitch.
Slowed Digestion: Dehydration can reduce blood flow to the digestive system, slowing gastric emptying and causing a full, uncomfortable feeling that may pressure the abdominal cavity and its membranes.
Poor Technique: Shallow, irregular breathing and weak core muscles are also major culprits that put stress on the diaphragm during exercise, often alongside inadequate hydration.
Preventative Measures: To reduce risk, sip water frequently throughout the day, avoid large meals before exercise, and practice deep, rhythmic breathing to support your diaphragm.

The Connection Between Hydration and Side Stitches

For years, athletes and fitness enthusiasts have pondered the link between a painful side stitch and insufficient water intake. The relationship is complex and often indirect, as several factors can trigger this uncomfortable abdominal cramping. Scientific research points to a few key mechanisms through which not drinking enough water can increase your susceptibility to a stitch. Dehydration can disrupt the delicate balance of electrolytes needed for proper muscle function, potentially causing the muscle spasms that feel like a stitch.

The Role of Electrolytes and Muscle Function

Dehydration isn't just about losing water; it also involves the depletion of vital electrolytes like sodium, potassium, and magnesium. These minerals are essential for regulating muscle contractions and nerve signals. When your body is low on fluids, this electrolyte balance can be thrown off, making muscles, including the diaphragm, more prone to cramping and spasms. This involuntary contraction can manifest as the sharp, localized pain of a side stitch. Intense exercise, especially in hot weather, accelerates the loss of fluids and electrolytes through sweat, increasing this risk.

Impact on the Digestive System

Another theory links dehydration to gastrointestinal distress that can mimic a stitch. When you are dehydrated, your body diverts blood flow away from the digestive system to supply working muscles, which can slow down digestion. This can cause a number of issues:

Sluggish Digestion: With less blood flow, the digestive process becomes less efficient. This can lead to bloating and discomfort as food sits in the stomach for longer than usual.
Irritation of the Peritoneum: Some researchers suggest a side stitch is caused by the irritation of the parietal peritoneum, the membrane that lines the abdominal cavity. A full or distended stomach from slow digestion could increase friction on this membrane, leading to a stitch-like pain.
Constipation: A chronic lack of water can lead to constipation, as the large intestine absorbs more fluid from stool, making it hard to pass. This can also cause abdominal cramping.

Other Common Causes of Side Stitches

While dehydration is a significant factor, it is rarely the sole cause. A side stitch, or ETAP, is a multifactorial issue influenced by several physiological and behavioral elements.

Mechanical Stress: The jarring motion of activities like running puts stress on the ligaments that connect the abdominal organs to the diaphragm. This can cause irritation, resulting in pain. Weak core muscles can exacerbate this effect by providing less stability. Poor Breathing Technique: Shallow or irregular breathing, especially during intense exercise, can put strain on the diaphragm muscle, leading to painful spasms. Deep, rhythmic breathing helps relax the diaphragm and is often recommended for both prevention and relief. Pre-Exercise Meals: Consuming large meals or high-sugar drinks too close to exercise can also trigger a stitch. The body requires extra blood to aid digestion, which can be diverted from the diaphragm, potentially causing a cramp. Some fluids, particularly sugary ones, also empty more slowly from the stomach, causing additional pressure.

Hydration Practices: A Comparison

To highlight the best practices for hydration, here is a comparison of different approaches and their effects on preventing side stitches.


Hydration Strategy	Impact on Side Stitches	Notes
Sipping water frequently	Decreased risk	Prevents dehydration and electrolyte imbalance without overwhelming the stomach.
Gulping large amounts of water	Increased risk	Can cause stomach distension, putting pressure on the diaphragm and increasing the likelihood of a stitch.
Drinking sugary sports drinks	Increased risk	Hypertonic solutions empty slowly from the stomach and can aggravate the parietal peritoneum.
Drinking electrolyte-rich fluids	Decreased risk	Helps maintain proper fluid and electrolyte balance, preventing muscle cramps, especially after intense exercise or in hot weather.

How to Prevent a Side Stitch

Prevention is the most effective strategy for managing side stitches. By adopting a multi-faceted approach, you can significantly reduce your chances of experiencing this pain.

Hydrate Consistently: Drink water throughout the day, not just before or during exercise. Aim for small, frequent sips rather than chugging large amounts at once.
Time Your Meals: Avoid eating a heavy meal within 1-2 hours of a workout. Opt for a light, easily digestible snack if you need fuel closer to your activity.
Focus on Breathing: Practice deep, diaphragmatic breathing. Exhale slowly as the foot opposite your stitch-prone side hits the ground to help regulate your breathing and relieve spasms.
Strengthen Your Core: Building stronger core muscles can help stabilize your torso during exercise, reducing mechanical stress on the diaphragm and abdominal ligaments.
Warm Up Properly: A proper warm-up increases blood flow to your muscles and prepares your body for the physical demands ahead, reducing the risk of a stitch.
Pace Yourself: Gradually increase the intensity and duration of your workouts. Pushing too hard too fast can overtax your system and lead to a side stitch.

The Connection to Electrolytes and Overall Well-being

The relationship between hydration, electrolytes, and muscle health extends beyond exercise. Chronic, mild dehydration can lead to a host of problems, including fatigue, headaches, and general malaise. By ensuring you are consistently well-hydrated, you are supporting your body's essential functions, from proper muscle contraction to efficient digestion. Using electrolyte-rich fluids, especially when sweating heavily, can be beneficial. For a deeper dive into the science of hydration, see the National Institutes of Health (NIH) website.

Conclusion

While not the single cause, not drinking enough water is a significant contributing factor to getting a stitch. Dehydration leads to electrolyte imbalances that can trigger muscle cramps, including the diaphragm, and can also slow down digestion, increasing abdominal pressure. Combining consistent, smart hydration with other preventative measures like proper breathing, timed nutrition, and core strengthening offers the best defense against this common exercise-related pain. Listen to your body's signals, stay adequately hydrated, and you can significantly reduce your risk of suffering from a stitch.

Frequently Asked Questions

A side stitch is a sharp, localized pain in the abdomen, medically termed exercise-related transient abdominal pain (ETAP). Its exact cause is unknown, but leading theories point to diaphragm spasms, mechanical stress on abdominal ligaments, and irritation of the abdominal lining, often triggered by dehydration, poor breathing, or eating too close to exercise.

Dehydration can cause muscle cramps by disrupting the body's electrolyte balance. Electrolytes like potassium and sodium are crucial for muscle function, and when their levels are low, muscles may involuntarily contract and spasm, which can feel like a stitch.

It is better to sip water frequently and consistently, especially before and during exercise. Chugging large amounts of water can distend the stomach and put pressure on the diaphragm, potentially triggering a stitch.

Yes, some studies suggest that drinking sugary or hypertonic fluids before or during exercise can increase the risk of a side stitch. These drinks empty more slowly from the stomach, causing pressure and irritation that may lead to cramping.

The best hydration habits include drinking water regularly throughout the day, not just during exercise, and replenishing lost electrolytes, especially after intense workouts or in hot weather. Electrolyte-rich drinks can be beneficial in these scenarios.

Yes, strengthening your core muscles can help prevent side stitches. A strong core provides better stability for your torso during exercise, reducing the mechanical stress on the diaphragm and abdominal ligaments that can lead to pain.

Other factors include improper breathing techniques, weak core muscles, eating large meals or sugary drinks too close to a workout, and the jarring, repetitive motion of certain exercises like running.