Thousands of fans flock to Coney Island in Southern Brooklyn on the Fourth of July for Nathan’s annual Hot Dog Eating Contest, not far from our own medical practice.  Last year alone 1.5 million more fans were watching on ESPN , making this competitive eating contest the best celebrated event in the sport.  Hosted at Nathan’s Famous Hot Dog stand nearby in Coney Island, the event attracts a number of corporate sponsors, including the highly relevant addition this year of Pepto Bismo as major sponsor.

For many the event has become an Independence Day tradition, as much as a barbecue with friends or waving the American flag in a parade. The Hot Dog Eating contest is entertaining, to be sure, although difficult to imitate for amateurs. In fact many of the athletes have a condition where their stomachs can become distended below the bottom of the rib cage.  While most peoples’ stomachs rest at the top of their abdomen, just at the bottom of the rib cage, these athletes are make use of the condition to make more room to eat the massive quantities of food necessary in their competition. Outside of these athletes this condition would be a troubling indicator of larger GI health issue, which is worth exploring further.

The cause of a distended stomach most often comes as a consequence of chronic overeating, which admittedly is an advantage part of the competitive eating. For example, Six-time champion Kobayashi has a condition where his stomach sits lower and can extend further and fill with food without creating painful pressure. However in ordinary circumstances this condition would cause a great deal of discomfort for one of our patients, who suffer in part because of their own overeating habits.