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This must be a runner’s worst nightmare.

Posted May 20 2010 12:00am

Now that racing season is approaching, I’ve had a few emails from runners who are completely terrified of experiencing “runner’s trots” (an urgent need to have a bowel movement that sends you in a panic towards the nearest toilet). Other symptoms include cramping, nausea, and flatulence.

Runners aren’t always open to talking about this, but it’s fairly common. I’ve seen statistics that range from 20-60% when calculating the percentage of runners for which this is a major concern. I’ve found in searching through books about running that this is not an issue that is generally addressed. So I’m going to cover it here.

Experiencing a bowel movement in the middle of a race is hardly fun. Everyone eats differently and digestion varies, but during a race (especially longer distances) most of the blood flow that normally goes to the gastrointestinal tract (your digestive system) gets diverted to your legs instead. This blood flow diversion can reach as high as 80%, and as a result many runners experience some sort of stomach issue.

If this is a recurring problem, runners should seriously consider keeping track of exactly what they eat and drink, as well as what time of day they experience their bowel movements. Keep in mind that food has a travel time:

  • From the moment you swallow to your stomach = 15-20 minutes
  • From the moment you feel full to elimination = 4-6 hrs
  • From the moment you swallow to elimination = 12-24 hrs

1. Eat (something small) approximately two hours before a race, and avoid eating after that. The presence of food in the stomach can make things worse. You shouldn’t be eating any big meals 4-6 hours before your race.

2. Make sure you’re hydrated. Dehydrating yourself will not prevent you from eliminating. On the contrary, it slows the body’s ability to digest food properly and will further add to your discomfort.

3. Avoid taking Asprin or ibuprofen or naproxen before your race. These are non-steroidal anti-inflammatory medications that have a tendency to irritate the gastrointestinal tract and make digestive symptoms worse.

4. Avoid excessive doses of Vitamin C, particularly if you’re supplementing this Vitamin as opposed to getting it naturally through food. Vitamin C is a diuretic and in excess, it will cause diarrhea.

5. Avoid high fiber foods and dairy products close to a run. Dairy tends to be difficult to digest and could aggravate stomach issues. It also produced phlegm. Safe foods include: bananas, pasta, oatmeal.

6. Avoid caffeine. It will speed up the movement of waste.

7. Relax! Stress will worsen these symptoms.

8. Allergies could be an issue. If you suspect that’s the case, you could try an elimination diet a few weeks before or after your race. This is done by eliminating all suspected food culprits from your diet completely for two weeks, then reintroducing them one by one, separated by a span of two days. See if there is any reaction. The most common culprits are wheat and dairy products.

9. Over-the-counter anti-diarrheal medications may provide temporary relief, but they are not recommended for use on a regular basis. Antacids may work against you if your symptoms are a result of too little stomach acid as opposed to too much (both extremes produce the same symptoms and feel exactly the same, but because antacids always lower stomach acid, they have the potential to make things worse in cases where you actually need more).

10. If problems persist, be sure to consult a health care practitioner to rule out the possibility of irritable bowel syndrome.

Your stool will tell you a great deal about your digestion and your overall health as a runner. It sounds silly, but you should always look at it.

Healthy stool should be a golden brown colour, as a result of the bile in your body. If it is grey, that’s a sign that you may have issues with your gall bladder. If it’s too dark, that usually means it has been in there for too long and you may be constipated.

Stool should be soft. When you flush the toilet, watch it go down. It should immediately break up and disperse with the force of a flush as opposed to going down firm.

Ideally, you should be eliminating approximately 18 inches per day, or the distance from the tip of your middle finger to the crook of your elbow. Bowel movements more than once a day are ideal. Less than once a day is not enough.

If you’re having trouble excreting, try the following tips:

1. Go the bathroom 15-20 mins after eating whether you feel like it or not. Just sit there even if nothing comes out. Your body will often get the message and eventually start eliminating. NEVER force anything out. Straining will cause damage.

2. Raise your legs and put something underneath your feet (like a stepping stool) to assume more of a squatting position on the toilet. This squatting position facilitates the process. (See photo above.)

This is the process of removing feces and other toxins from the colon and intestinal tract. I’ve never personally had this done, but I’ve heard that it’s amazing 1-2 days before a big event like a race.

It will make you a little sleepy immediately afterwards (the same sort of feeling after getting a massage), but after that you are bursting with energy. I’ve heard of brides who have this done the day before their weddings because it flattens their stomachs, and businessmen who come in the night before a big meeting because it helps them think more clearly and feel alert the next morning.

Yesterday I heard a woman who administers this type of cleansing tell a story of a 70+ year old man who had this done and found a closed safety pin that he had swallowed as a toddler (identified by his mother, who thoroughly documented it in his baby journal)!

I think there’s something to be said about this process. However, if you suffer from any kind of bowel disease or colon cancer, you should not have this done.

This is another concern for runners, usually the result of weakness of the pelvic floor. Urinary leakage can occur when sneezing, or with other sudden movements.

Pelvic floor exercises are 90% effective in stopping urinary leakage. Sam Murphy and Sarah Connors describe these exercises in Running Well. Gentlemen – this next bit was written for women:

Sit, stand or lie with your legs slightly apart and your buttocks, abdominals and thighs relaxed. Now pull “up and in” as if you were trying to stop yourself from urinating (don’t literally do this on the toilet, however, or you may cause a urinary tract infection). Breathing normally, continue to pull up and in through the vagina and anus. The most common mistakes are to pull in the stomach or clench the buttocks. Make sure you are doing neither. Build up to 10 x 10 second holds.

Once you think you’ve got the hang of that, try the “lift” exercise. Draw the pelvic floor muscles up to the “first floor” and hold. Still breathing freely, now draw them up further to the “second floor.” As you get better at these, you can increase the height of the building and go up to the “third” or “fourth floor”! Mix both fast and slower contractions for best results and do these exercises as often as you can.

You can also search for these types of exercises as videos on YouTube.

Sometimes the urge to urinate will be brought on because of nerves, or because you genuinely have to go. So just go.

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I’m planning to focus most of my future summer posts on racing issues such as these, and hopefully help make everyone’s racing experiences this season a little more pleasant!

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