Training Talk...............................

A Marathoner’s Bane: Runner’s Trots
By Susan S. Paul, MS, TSF Training Program Director

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Many distance runners experience an upset gastro-intestinal (GI) tract on long runs or during their marathon. While this ailment is not usually considered “normal” conversation in most circles, for runner’s this discussion is all too common. If you suffer from this condition, there is HOPE!! Start altering your diet and energy supplements NOW to find out what helps you BEFORE your race date! The most common causes of GI upset are due to daily nutrition, sugar in energy drinks and supplements, and/or the physical stress of long miles, heat, and exertion levels.

Runners now have a very wide variety of energy supplementation products to choose from, so try a few different products and see if one brand is better for you than another. The heat of summer has hopefully left us for good, so if heat has been the cause of your GI upset the cooler weather may bring you some relief. Is your run pace comfortable? Make sure you are not pushing too hard on the long runs. Exertion levels can trigger a GI upset. Also, record what you eat the night before a long run in your training log and see if there is any correlation between your dinner the night before and your bathroom stops. Personally, I have found that Chinese food is not best thing for me to eat before a long run!!

Having suffered from GI upset on many long runs and in many races, I found the following article written by Dr. Parker on the Galloway website to be very helpful and informative.

~ Enjoy! Susan

Injury Archives: Runner's Trots
by Dr. Frederick W. Parker, III, M.D.

Both upper and lower gastrointestinal disorders are common in distance runners. Although upper GI complaints are common and sometimes predominate in many surveys, lower GI complaints seem to occur more frequently in women and younger runners. Commonly known as "runner's trots," many surveys suggest that one-fourth to one-third of recreational marathoners and triathletes have experienced diarrhea during or after distance events. Many of these symptoms correlate with the degree of exertion. The cause of runner's diarrhea is thought to be probably ischemic or lack of blood flow to the bowel as the body diverts blood from the GI tract to the working muscles. Normally, the gut tolerates this diversion of blood flow, however, in many athletes the lining of the gut becomes irritated and diarrhea ensues. The severity of diarrhea is dependent on the level of effort, the neurogenic response of the gut in particular patients, the level of conditioning and degree of dehydration.

A few things that may help combat some of these symptoms: First, keep yourself well hydrated by consuming five to eight ounces of water every 15-20 minutes. Dehydration slows the body's ability to digest foods and sets the stage for intestinal trouble. Next, avoid eating within two to three hours of your race, especially foods that are high in fat. Do not use aspirin or non-steroid agents such as Ibuprofen since they may cause GI irritation. Avoid drinks that contain more that 10% carbohydrate (sugar) content. Make sure you drink water or sports drinks that are low in carbohydrates (5 to 8%). You may take limited antacids since they may help the nausea but use them sparingly since they may cause abdominal cramping during exercise.

Establish some time for "pre-run" elimination routine; including getting up early and eating (possibly coffee and a light meal), since this may get your system “running” before you run. Also, cut back on the consumption of dairy products, sugary foods, and avoid excess coffee since this over stimulates the gut. Additionally, try training at different times of the day especially if the morning running tends to cause diarrhea. As a final tip, avoid sorbitol breath mints or gum as well as large doses of vitamin C since this may cause diarrhea.

In Summary

• Don't eat anything in the morning before the race or long run.
• Drink water only; no other beverages.
• Cut down on eating from 4 p.m. on the night before the race or long run. Normal portions may be too much. It's okay to snack on toast or an energy bar. No fat or roughage.
• Heat is a major stressor on the body; heat may be the cause of your runner “trots”.
• If these things don't work, try an anti-diarrheal medication the night before and/or one hour before the run.
  
  MOST IMPORTANT- try these tactics during YOUR TRAINING!!! The night before the race or the day of your race is NOT the time to try something new!!!
  
  Frederick W. Parker, III, M.D. Manassas, VA
  American Running and Fitness Association Newsletter
  July 1998, Volume 16 Number 7