How Do You Spell R-E-L-I-E-F??

From time to time most runners will experience some type of stomach distress while on a run. The causes of stomach distress while running are many. Anyone can be caught off guard by the lunch that didn't agree with them or the stomach bug that's been going around the office. That type of distress, usually means a trip to the rest room and maybe a day or two laying off the running until the ole tum tum gets to feeling better. While other stomach issues may be the reoccurring type that can really affect a runner's performance on an ongoing basis.

Below are several common stomach distress issues experienced by runners as well as a few recommended remedies. The remedies may not work for everyone, but they may be worth trying just in case it's the "cure" you've been looking for.

Nausea #1—While running, blood goes to the parts of the body where it's needed most....the legs. When this happens, the lining of the stomach isn't receiving its normal blood flow causing an overload of stomach acid resulting in the runner feeling nauseous.

Remedy: Taking an antacid such as Tums, Rolaids, or Maalox prior to your run may help neutralize the acid.

Nausea #2—You don't want to feel stuffed, but neither do you want to feel starved on a run. Running on an empty stomach can cause nausea that comes when the hunger pangs kick in.

Remedy: Eating a 200-400 calorie snack about 1.5-2 hours prior to your run can provide you with the needed energy to sustain your run as well as keeping the hunger pangs at bay. The snack should consist of mostly complex carbs and a little protein. For a short run the 200 calorie range will do. For a long run or a more intense workout such as hill repeats or intervals, the 400 calorie range will do.

Nausea #3—Carbs are the fuel needed for energy production. However, like most things...too much of a good thing can be a bad thing. Today we're bombarded with sports drinks, gels, chews, beans, wafers, shots...the list goes on and on. All the ads make it seem like you need a constant influx of carbs while you run. You do need properly fuel your body before, during and after your run, but your body is pretty miraculous. Your liver is able to store about 2000 calories of glycogen (carbs). If you're eating a diet rich in complex carbs on a daily basis, then chances are you're doing a pretty good job of keeping those glycogen stores full. Those 2000 calories will provide for about 18-miles worth of energy before the stores are depleted. The trick is not letting the stores get too low. Runners that let the stores become depleted run the risk of bonking or "hitting the wall" on those really long runs. However, that doesn't mean downing a GU every 20 minutes. Ingesting too many carbs too frequently can cause stomach cramps. Washing down a concentrated sports gel with 6-8oz of water instead of sports drink can help the body absorb the carbs without overdosing on carbs. When you overload your body with more carbs than it needs, you can cause your body to release too much insulin causing a "yo-yo effect" with your blood sugar resulting in nausea. 

Remedy: Eat a 200-400 calorie snack of complex carbs about 1.5-2 hours prior to you run. During the first 45-mins to 60 minutes drink water. After this length of time begin drinking sports drinks to provide the needed carbs and electrolytes. About every 45-60-minutes take a gel (if desired), but be sure to wash it down with water not sports drink. Be sure to test different combinations of sports drinks and gels. Some runners, may find that a sports drink with carbs and electrolytes will be enough to sustain them on a run. Others may find a combination of sports drinks and gels work. While still others may find that a sports drink and solid food like pretzels work best for them. Be sure to do your testing well before race day.

Stomach Cramps/Indigestion—As mentioned in Nausea #1, the body diverts blood flow to where it's needed. Running shortly after eating slows the blood flow to the stomach, which in turns slows or stops the digestion process. So any food eaten just prior to running will more than likely just sit in your stomach, go no where, and do nothing but cause stomach distress.

Remedy: Eat about 1.5-2 hours prior to your run. 

Diarrhea—Loose bowels are pretty common amongst runners, especially on longer endurance runs. The cause can be anything from anxiety to diet.

Remedy: Try various relaxation techniques from meditation to yoga to help relieve stress and anxiety prior to a race. If you're traveling to a race, try to arrive at least two days prior to race day. This will give your body time to adjust to its new surroundings. Also, you'll be less stressed about finding the race expo, the starting line, etc.  Eat high-fiber meals about 2-3 days out from race day. This will help stock your carb stores and give the high-fiber foods time to pass through your system prior to race day. Switch to more simple carbs the day before and morning of the race. Avoid foods that cause peristalsis

Sloshing Stomach—Ever feel like you're drinking a lot on a run, but the water just stays in your stomach sloshing around? Sodium is one of 5 electrolytes needed by the body to help keep things in balance. Sodium plays a vital part in hydration and water balance in the body. On long and/or really hot runs, you can actually deplete your sodium levels through sweating. Once depleted, your body has no way to transport that water sitting in your stomach to the rest of your body, so it just remains there sloshing around.  

Remedy: Drink water for the first 45-60 minutes of a run, but then switch to a sports drink containing electrolytes. Also, be careful not to overhydrate the day before the race. If you're drinking too much water the day before, you can run the risk of flushing out your electrolytes before you ever get to the start line. Drink throughout the day before the race, but just not to excess. Also, eating salty foods such as pretzels along with the water can help to ensure good sodium levels on race day.

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!