Runners Tum

Just don't know what to do!!!!!

14 messages
17/07/2012 at 12:58

Hi all,

I wonder if anyone could help me. I suffer from absolutely dreadful runners tum. 

It's been going on for a couple of years now but is getting worse and worse. I don't eat for at least 3 hours before running (often more), I take Imodium and I ensure I'm well hydrated but nothing seems to help.

I used to get it only on longer runs or where I was pushing myself (a race or an intervals session) but now it's creeping into my easier runs too. I do think that nerves plays a part in it but the worse it gets the more I do think about it.

It lost me loads of time in the two marathons I've done and countless other races have found me in the bushes at least once. There have also been occasions where I haven't had any control iyswim.

I just don't know what to do now. I ran a half marathon on Saturday and was okay until about mile 10 when it kicked in big time. I purposefully hadn't eaten any breakfast and only fuelled for the race with some sports beans beforehand and 3 squares of Clif Shot bloks at the 6 mile mark. I have tried racing without the shot bloks/beans but still have the upset tum so I don't think they are contributing. 

I really think it is just the jiggling around that does it to me. I used to be very overweight and suffered with IBS but since I stopped eating rubbish that doesn't happen any more but maybe years of having it have left me weak gut muscles or something?

I'd be really grateful to hear any suggestions as a nappy is looking like the only option and although I can have a joke about it afterwards it really isn't very funny at the time!

Thanks

Rose. 

17/07/2012 at 13:36

Hi Rose,

Really sorry to hear you're having so many problems!

A few questions:

What is your diet like? Maybe give us a typical day's intake?

What do you drink before/during runs?

How are your bowels outside of running (if you know what I mean!)?

There are lots of things that can cause tummy problems for runners, and usually they can be improved without resorting to a nappy. Although there may be a business opportunity in technical pants that hasn't yet been tapped into

 

17/07/2012 at 13:57

Hi Sarah,

Thanks for your reply. 

My diet is fairly good (I think!!). I calorie count a lot of time but also try and ensure that I get a good proportion of fruit/veg and try to steer away from processed food as much as possible (I'm not obsessive about this though).

A typical day

Breakfast: 2 Eggs scrambled (no butter) or Berries and Greek 0% Yoghurt or a granola bar (when I have no time!)

Mid Morning: Something from my graze box: handful of nuts, some dried fruits etc

Lunch: Big mixed salad (including chick peas) with lite mayo and 2 boiled eggs OR a granary baguette with salad and avocado 

Dinner: Chilli and rice or Steak and Sweet Potato with roasted veg 

I drink black coffee and drink about 1 litre of water a day (I aim for 2 but often forget)

I usually have an apple or a banana at some point during the day.

When I have a race I tend to have wholemeal pasta with mixed veg and a tomato sauce for dinner the night before. I do have this at other times too and it doesn't have any ill effects then. I have a bit of a race day routine now whereby I get up at 6am and have breakfast (I either have a granola bar or some porridge) and I then have 2 cups of coffee quite quickly as this tends to make me 'go'. Then I wait until about an hour before the race and take 2 imodium!  

17/07/2012 at 14:01

I really wish I could give you some helpful advice, I have suffered from this for years, (I had a 12 year break and it happened before and since I started again at the start of last year) and in all honesty I don't think there is ever a run where I don't need a comfort break (including the stinging nettle episode last week !!)  Sometimes more than once - I always run first thing in the morning so am running on empty, always make a deposit before I go out - I will admit to probably being dehydrated - and have resigned myself to having the problem. 

I had a health check up last week and found that apart from a cholesterol level of 5.8 I am other wise healthy so I mentioned it to the nurse - her reaction was "we hear that all the time" To my question "could there be a trigger?" her reply was simply excercise.  I run at 5:30 am which means that there are few people about, and have resigned myself to carrying "poo" bags and pretending I have a dog.

17/07/2012 at 14:53

Ok, some thoughts.

Your diet is pretty healthy - lots of nutritious food. But - and this is something you'd have to test - it may be too fibrous. Not for general eating, but when combined with exercise, which alters the physiology of the gut.

When you undertake sustained activity - typically 60 minutes plus, several things happen that can affect the way your gut works.

Firstly, blood flow to the gut is reduced in favour of increasing blood flow to the working muscles. This can cause GI symptoms including cramps, nausea, vomiting and diarrhoea. Secondly, you get dehydrated. Dehydration further reduces the flow of blood to the gut which can exacerbate GI symptoms. Thirdly, you get hot (even in British summer conditions!), and this - guess what! Further reduces blood flow to the gut

So lots of things going on in the way the gut is working. 

When you consider putting something in to be digested - there's obvious scope for even more problems. However - and here's a key thing to remember - one of the best ways to increase blood flow to the gut and to reduce some of the problems of dehydration, is to keep stomach volume relatively high. The more there is in the stomach (up to a point - you don't want to be gorging yourself!) the greater the flow of blood. The easiest way to keep stomach volume high and to reduce the effects of heat stress and dehydration is to drink. Water with added electrolytes as a minimum, but adding some carbs in will obviously help to keep energy levels up (either a sports drink or gels/shot bloks/similar along with some water). If you do want to take on carbs - recommended for marathons - then you need to practise and train the gut to tolerate whatever it is you do. 

Going back to the fibre issue - when you combine a fibrous diet (which gives the bowel a lot of work to do) with activity that reduces the efficiency of the bowel, then your almost setting yourself up for a problem. This won't apply to everyone - some people seem to be immune to tummy problems - but as you have a history of IBS and ongoing problems with runner's tum symptoms then it would be number one on my list of contributing factors. 

I'm not advocating cutting the fibre out of your diet - as I said, it seems a very healthy diet. But you may want to look at the timing of what you're eating. Avoiding certain foods in the hours before training and the day before a race may well help. It's certainly worth experimenting with. Try these links for more info. 

Runners gut

Low FODMAP

Another thing to consider is the mechanical 'jarring' that comes from running. Some people seem to be more susceptible to this than others, and there's a school of thought that proposes having a strong core can 'buffer' the intestines. So lots of planks and the like may help.

And finally - caffeine can easily irritate the gut. People with IBS and other GI complaints are often advised to cut caffeine from their diets. As you don't have tummy troubles outside of running it probably isn't necessary to cut it out completely, but avoiding it the day before/day of a race may help, as may avoiding it in the hours before a training run. It may be something worth experimenting with.

I hope something in there helps! Any questions, please ask

17/07/2012 at 15:47

I know it wasn't my thread Sarah but that is a very helpful reply - certainly more than being told exercise triggers it and saying see you in 3 months.

17/07/2012 at 15:51

Thank you sooooo much Sarah, that's all really useful information and gives me something to work on.(well lots of things actually but I'll go one step at a time)

I'll definitely start with the caffeine and the fibre issue. I always have wholemeal bread and pasta and HEAPS of veg in that pasta too! 

One other question; one of those articles mentions not self medicating. Would you suggest that I shouldn't take the imodium? I only do it for races, not for normal runs.

Thanks again. Like Grendel says, it's great to actually be given some advice rather than told that it's common!

Rosex

17/07/2012 at 16:25

I aimed it at Rose, but I did hope that it would be helpful/informative to you too Grendel And I really do hope something in there helps! 

Unfortunately a lot of medical people just don't get exercise and exercise related problems - I'm one of those rare few who exercises myself, plus I have tummy problems, so if I can help anyone else then I will!

One other things I should have mentioned is that worrying about it can easily make it worse. The gut is very responsive to stress/anxiety, so if you can avoid fretting about it (where the next toilet is, etc.) then you may find that your tummy feels a bit calmer for it. 

Re. self-medicating. Some people see it as an essential part of their race preparation, but it's not the best routine to get into. If you've tried Imodium or similar and they've not helped, then the question is - why continue? The way Imodium works is to slow down gastric transit - so things move more slowly through the gut. This is something you want to use regularly as it can affect the function of the bowel when you're without it, and no one wants to be hooked on Imodium 

If, after trying dietary modification/relaxation techniques, you really find that you can't manage without, then there's nothing wrong with using Imodium occasionally. For best effect you need to get the timing right. An hour or so before the race, or if you know the problem isn't likely to strike until a couple of hours in, carry the Imodium instants to take an hour before the problem usually occurs. I can't be precise with times - that's just to illustrate! Take them too far in advance and you lose some of the benefit, leave it too late and they won't prevent the problem. It may be self-medicating, but quite frankly most pharmacists/GPs wouldn't have a clue what to advise regarding anti-diarrhoeals and running anyway!

 

MK1
20/08/2012 at 14:47

Wow, I am so glad I found this thread. I also suffer from this problem. It has only really started in the last month (I have been running now for approx 12 months) and not only is it getting me down on my training runs, it is now making me question what races I can and cannot do as I am worried if I will be able to find a bush in time!!

I am also finding that on rest days or days when I cross train I am now not going to the toilet at all and only go once I start running. (Usually in the first 3 or 4 miles). I then need to find a bush within a mile to avoid any embrassment!!

Having looked back at all the advice, I can say that I have a very healthy diet, very similar to Rose's except I tend to have fish for dinner rather than red meat. I also keep myself well hydrated. I am going to cut out my caffeine intake from now (usually 2 cups a day) and also check my fibre intake too. I tend to run in the morning, so usually have an empty stomach, though the time of day is immaterial.

I have a half marathon on Saturday, so after reading your advice, I am going to take some imodium an hour before and keep my fingers crossed.

20/08/2012 at 15:34

Sarah - are you going to send through your bill? that's fantastic advice!

MK1
28/08/2012 at 11:17

Entered The Thames Meander half marathon at the weekend. Had very loose stools in the morning and was quite worried. However, after taking the advice of several posts on this thread I took 2 imodiums (one an hour before the race and the other 20 minutes before). No problems through the race at all, no worries in my head....even got a new PB!

I will ensure I do not use imodium unless it is a race (for long traning runs I will still stick to the bushes) but I am already feeling far more happier and confident now about the marathons I have coming up over the next couple of months.

03/09/2012 at 21:16

I suffer with exactly the same problem and truly sympathise! I also need to take something to help before running in half marathons but have been caught out when training with local running club and had to dive for a bush.... I know if I get anxious/stressed it makes it worse ....From discussing with fellow runners it seems to be quite common and we're not alone!!

03/09/2012 at 21:48

is it possible to try a low fibre diet and include some Buscopan to relax any spasms from running and maybe try a few runs in a week where you have not consumed any dairy (ie greek yogurt/milk etc) if before your run swap your normal cliff bars etc (if they contain a sweetener that may upset your tum like malitol does for me)

take a shot glass full of chia seed and down it with water, (it swells like that plant feed gel) it should keep you hydrated too and as it is a high protein/omega etc superfood it may help keep you sustained, there are many websites that claim that chia is great (for want of a better word) toilet emergencies and to quote from one source " The water-absorbing properties of the chia seed make it an excellent remedy for diarrhea. Other uses include as an energy booster and treatment for constipation and other intestinal problems. Chia seeds help the body maintain its fluid and electrolyte balance, which are thrown off when the body is suffering from diarrhea. Only a small amount of chia seeds are necessary to cure the discomfort of diarrhea"


Good luck


MK1
05/09/2012 at 14:13

I will definitely try the chia seed. Thanks for that


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