Monday, October 12, 2009

Say Goodbye to the GI Distress Blues!

Nausea, bloating, diarrhea, Oh my! I need a port-o-potty or I'm gonna die! Ever been on a long run only to have your stomach tell you you should have turned about about 5 miles back? There's probably not a runner alive that hasn't experienced some type of GI distress while pounding the pavement. Actually, GI distress is one of the most reported reasons why runners drop out of or don't do as well as expected in an endurance race.

GI distress can be blamed on an array of different things from something as simple as just the normal jostling of stomach contents during running, to eating something that disagreed with you, to eating too soon before running, to having a virus or stomach bug. I read an article once that said the way to avoid GI distress was to avoid eating before, during, and after running. Brilliant, don't you think?! I wonder how many studies it took to come up with and prove the theory that if you don't eat anything you won't have stomach-related problems during a run. Well, however correct that research might be, the problem is that avoiding food (solids and liquids) can spell disaster for a runner in a host of other areas—dehydration, bonking or hitting the wall from lack of sufficient glycogen stores, just to name a few.

Now, I'm no scientist, but I don't think avoidance of food is the answer. There is no one sure-fire way to avoid GI distress, because we're all so different. What works for one runner may spell disaster for another. So, it will involve a little trial-and-error to determine what works best for you. But don't fret, there are several things you can do to keep GI distress at bay and calling the Roto-Rooter Man isn't one of them! Listed below are a few tips to try.

During your training, be "body aware." Don't wait until race day to decide to work on your GI distress issues. Make note of days during your training when you experience GI problems. Right down the symptoms and what you ate and/or drank. Do this each time a problem occurs, soon you may see a pattern occur which will help you decide how to change what you're eating, the amount of what your eating, or when your eating it.

Make sure you're well hydrated. Good hydration is key to the digestive system working well. Good hydration doesn't mean downing 32oz of water 30 minutes before you run, however. Make sure you're hydrating throughout the day.

Drink the proper types of fluids for the race you're running. If you're running less than 60 minutes, water will do just fine. Taking in too much simple carbohydrates (found in many sports drinks) can cause GI distress. If you've carbed-up prior to the race, you should have a sufficient amount of glycogen. Drinking a lot of sports drink for shorter races can be overkill, sometimes causing nausea or diarrhea. There are many different types of sports drinks on the market. Sports drinks best suited for longer runs have electrolytes and 6-8% carbs. These sports drinks usually contain about 120-170 calories per 500 ml of fluid. (Examples: Accelerade, Gatorade [original], Gatorade Endurance Formula, Powerade [original], PowerBar Endurance Sport [powder]) Some sports drinks are actually designed to be used after a race to help you quickly replace the carbs you've burned. These drinks usually contain about 10-15% carbs and usually about 240-320 calories per 500 ml of fluid. These higher carb/higher calorie drinks are designed to replenish carb levels after exercise. (Examples: Endurox R-4, Gatorade Performance Series, PowerBar Performance Recovery, Isopure Endurance) I've discovered that 100% coconut water works well as my sports drink. It naturally has all the carbs and electrolytes you need. Actually it has 15 times more potassium as most sports drinks, which helps keep my calf cramps at bay. You'd think coconut water would be sweet, but it's not. It actually does very well with my stomach. I've been using coconut water as my sports drink for the past few months and have not experienced any GI problems or calf cramps. If you decide to give it a try, be sure to get 100% coconut water, not milk.

Sports gels are a great source of carbs during an endurance race, but if you're drinking a sports drink and ingesting sports gels you could overload your body on simple carbs causing GI distress. Experiment with the right combination of sports drink and sports gels during your training runs. When I take a gel on a run, I make sure to wash it down with water not a sports drink.

After about an hour of running, it's a good idea to switch from water to drinking a sports drink for two main reasons—resupplying your glycogen stores with the carbs provided in sports drinks and resupplying lost electrolytes (sodium, potassium, etc.). Sodium is lost through sweating and sodium is a key element in hydration. It's needed to help your body absorb the fluids you're ingesting. Ever had that sloshing feeling in your stomach? It's most likely due to lack of sodium. The fluids just sit in your stomach because there's not enough sodium to help your body absorb the fluids. This lack of sodium and dehydration can slow the emptying of your stomach which can cause GI distress. Be careful, though, if you're properly hydrated and your sodium levels are fine, then taking in too much sodium can lead to nausea and vomiting.

Over-the-counter medications can also be helpful. If you're pone to diarrhea while running, taking something like Imodium before the run, may offer some relief. Some runners even carry it with them and take it while on the run to prevent the "runs." Best to check out this course of action with your doctor, especially if you're taking other medications.

Carb-loading usually begins three days prior to the big race. Best course of action is to eat your high-fiber more complex carbs on the first day, weaning off to more simple carbs on days 2 and 3. This will provide time for the high-fiber foods to pass through your system. The simple carbs on days 2 and 3 will help keep your glycogen stores topped off until race time. Be careful that the simple carb foods aren't high-fat foods, that might come back to bite you in the race too!

For many runners, caffeine provides a great boost before a run. For other runners, it may provide the wrong kind of "boost." Caffeine is a stimulant which can cause peristalsis (automatic muscle contractions that occur through the digestive track to get food moving through your system). If caffeine easily sets peristalsis into play for you, then avoid caffeine before and during running.

Anxiety can cause GI distress. A big race can be very stressful, especially if you've traveled to an unfamiliar city. If at all possible, arrive 2 days before the race so that you can better acclimate to your new surroundings. This will also allow you to pick up your race packet early—one less thing to worry about. Try bringing your own foods so you won't have to make any variances in eating from what you've done in your training. Also, try using various breathing techniques and/or yoga to help you de-stress prior to race time.

The simplest rule for avoiding GI distress (but probably the most ignored) is to never try anything new (food or drink) on race day that you haven't used during your training. No matter how many enticing gels, sports drinks, cookies, pretzels, and candy you're offered on the course, if you didn't train with them, DON'T USE THEM!


Relentless Forward Commotion said...

I had a horrible marathon on saturday due to GI issues. I followed all of the rules you provided, I'm still utterly confused as to why it happened. I will be trying imodium next race!

Unknown said...

It happened to me few times when i was going on a long run. My issue is i come abc from work at 6 pm i eat something and try to be out before it is too dark. The problem i never really digest my food and no way i could go on a run before i eat. So it is always challenging how my stomach digest my dinner. On a race day i eat a small amount of cereal over 3 hours from the start and i am good to go without a problem.

Unknown said...

Great stuff RunnerDude. I have been working on this all summer andI think I have it down for my race in two weeks (at least I hope so). The coconut water has really worked well for me and has not caused me any GI problems. I am glad I tried it early though, I would have been stressing about it before the race. What do you eat before a marathon?

Mark U. said...

Good post, RunnerDude! I just ran the Chicago Marathon Sunday, and fortunately everything worked-out well before the race as is ideal. I find that by waking-up at least three-hours before the race and drinking a couple of cups of coffee with my low-fiber breakfast cereal and low-fat milk is essential, since as you noted the caffeine helps accelerate the intestinal process. The evening prior to the marathon I try to avoid anything that I don't easily tolerate (I'm fond of easy-to-digest pasta and a low-fat meat-sauce, and specifically avoid high fiber foods/salads within 24-hours of the race).

Chad said...
Check it out, my results from my first 1/2 marathon. It was a wicked experience, and i am totally appy with the results. Cheers!

Chad said...

By the way, three weeks ago, I too had some GI issues km 7 into a 15 km run. I barely made it into the farmers field to let loose (so glad noone was around!). This had never happened before. I blame my asthma, actually, which sounds wierd, but my body was lagging and in distress. This lasted three weeks (the wiped out feeling) until I got treated at the hospital.

Laura said...

I need to work on this. I've taken Immodium before my past two races and paid for it after and during a race. Probably not the post healthy thing to do to keep from going to the bathroom.

RunnerDude said...

Hi Heather! I'm so sorry to hear about your marathon. Sometimes the reason is hard to pinpoint. I finally found using 100% coconut water as my sports drink to be the best solution for me. It naturally has all the carbs and electrolytes you need. Plus it has something like 15 times the potassium as sports drinks which helps me from getting calf cramps. It's also not very sweet and seems to do well wiht my tummy issues. I sue Zico cocount water, but there are other brands on the market now. Might want to give it a try.

RunnerDude said...

Hey Ness! After work, are you able to eat something small before your run like a granola bar, a sports bar, or a bagel with peanut butter or something like that and then eat something more after you run?

RunnerDude said...

Hey Noah! Before all my long runs including the marathon, I usually eat a toasted english muffin split in half with a little peanut butter and a little jam, honey, or preserves. It provides just the right amount of carbs without much fat or protein. I usually eat it 2-3 hours before marathon time. On a regular long run at home during my training, it's more like 1 hour before the run, and it still seems to do well for me.

RunnerDude said...

Hey Mark! You're right on the money. Eat those heartier carbs on day one of the carbloading, but switch to the more simple carb foods on days 2 and 3 for just the reasons you said. I you regular diet you'd want to eat more high fiber whole grains, but when it comes down to race time, you're concerned about fueling your body without having the go to the port-a-john at mile 10. Thanks for the info. Great as usual!

RunnerDude said...

Hey Ootaynee! Awesome time!!! Congrats!