Nausea on long runs / races

Note for the first time in a long race, I was sick at about mile 25 of a 50k and had painful stomache cramps. Weather was warm, but I was well hydrated and didn't feel over or under fed or watered. Wasn't pushing a fast pace either.

Really struggled to finish after being sick as felt weak. Not pleasant.

Any suggestions about what went wrong and how to avoid?

Were you actually sick? Maybe ate something that didn't agree with you?

How did you feel after the race? Has it happened before? Potentially just illness that coincided with the race?

How was training leading up to the race?

I was actually sick and stopped for a minute or two. At end of race I quickly recovered though. I've had nausea on ultras before. Training going into race was good with 2 marathons in the last month that went well. However both marathons were much cooler than the ultra that was about 28 degrees.

Anyone else have similar problems on long runs?

Could be lots of things:

• different breakfast/pre-race meal to what you normally eat?
• over-exertion?
• nutrition: too many sugary drinks/gels?
• do you need to think about salt replacement?
• nerves?

Doesn't sound like stomach bug.

Don't know about other people, but personally I'd struggle to run any sort of distance in 28 degrees, never mind an ultra. Maybe it was just the heat. For future hot races you could try wet buffs round neck and wrists to cool you down. And freezing your water bottles - you can hold them to cool youself down plus you can only drink the water at the rate they melt which helps prevent accidental over-hydration due to the heat...

I just read Scott Jurek's book which had some rather lurid descriptions of uncontrollable barfing episodes in races he went on to win, and also stories of guys who could vomit sideways while running a 7 minute mile without breaking stride. Pretty impressive!

" also stories of guys who could vomit sideways while running a 7 minute mile without breaking stride"

Sometimes I wonder if we are all uttterly bonkers.

Do you vomit to left or right?

Agree about the heat. The hardest race I ran this year was the Dunstable Downs Challenge - 27 or 28 degrees was REALLY sapping my energy. I only did the 20-mile option rather than the marathon, 'cos I had someone who was doing the HM waiting for me to finish, but I found it harder than NDW50 a few weeks earlier, basically due to the heat.

Re. "Eat and Run" (Scott Jurek's book), I also read that recently and yes, the idea of vomiting while continuing to run!!! 

only ultra i felt nausous on was one in heat.....i couldn't eat or hardly drink until 2 in the morning when it finally cooled down enough for me to return to feeling normal

I'd say cos of the heat too and perhaps resulting lack of salts?  Bloody well done on completing the race though, Hillheader!

PS: Brilliant book! I absolutely love any kind of running books, I don't think there's many left out there that I haven't read lol. Somebody please write some more

 I still have problems with nausea. Tried all sorts of things . salt/hydration is the cause of most of my problems. Weighing yourself before and after an ultra should give you some indication of state of hydration. I usually get to a tipping point if under hydrated where I just can,t re-hydrate/keep any fluid down. Any run at 28c would be a nightmare for me as I sweat profusely and can,t hydrate fast enough. On really long runs I have found I can crawl through periods of nausea (this can take several hours) then recover enough to re-hydrate and finish in really good shape having rested my legs while the nausea lasted. Interestingly I have found that stopping at an aid post and resting is no help with my nausea. 

Has anyone tried antacid tablets (calcium carbonate) when feeling nausea during a race/run? If so, have they worked? I find them useful for nausea which I sometimes get pre-race associated with nerves.

On the LDWA Hundred - and other walks/runs of 50 miles or more - nausea and vomiting is a common problem. Ken Falconer in his "Survivor's guide to 100s and other long walks" http://www.ldwa.org.uk/library/hundredsurvival/hundredsurvival.php recommends Bovril. Other suggestions are flat cola - a very common remedy, and milk. A different approach suggests that the nausea is a version of motion sickness - caused or worsened at night by the bobbing up and down of the light from a head torch. Personally I find that removing the head torch and holding it like a conventional torch is helpful!

The pre/during event nerves can be a cause.  I couldn't understand why on my first couple of long distance events I felt sick.  I don't think of myself as being particularly worrying sort, but when I look back, difficulties at work caused quite severe gastric problems, although it took me quite some time to realise this.  Once I made the connection between stress and feelings of nausea the problem seemed to resolve itself.

Another factor could be that feeling sick, for whatever reason, can lead to the vicious circle of not taking enough fluid+nutrition which actually makes you feel sicker so even less inclined to eat and rehydrate properly.

All the best and hope you find a cure.

I'm a bit late to this thread (!) but DB asked an important question that was unanswered - 'has anyone tried antacid tablets?'. The answer is 'Yes' !

I originally tried antacid (Tums, Rennies etc.) following anecdotal reports from the US; It works for me and I believe that it has 'saved the day' for a couple of people that I've offered them to mid-race.

I did some Google 'research' to get some idea of 'why' they might work (I'm not a doctor | don't really know what I'm talking about etc!) and Exertion-Associated GastroEsophageal Reflux is a commonly recognised condition resulting in heartburn, which can be alleviated with Antacid (but beware that heartburn pain can be indistinguishable from cardiac pain!).

It is also common to have reflux (stomach acid coming higher up the digestive tract than it should) that doesn't cause heartburn symptoms, but does cause nausea, sore throat, excessive phlegm etc. etc. (http://en.wikipedia.org/wiki/Laryngopharyngeal_reflux) which sort of fits!

I always carry antacid tablets on a long run (together with Paracetamol and Imodium Instants ) and take them 'as directed' if I feel even slightly nauseous.

OldAndCreaky: Thank you for responding - nice to know I'm not the only one who has found antacid tablets useful for this, and maybe a few more people will try them and report back.