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Injury Archives: Runner's Trots Don't eat anything in the morning before the race or run. Drink water only no other beverages. Cut down on eating from 4 p.m. on the night before the race or run. Normal portions may be too much. It's okay to snack on toast or a PowerBar. No fat or roughage (PowerBar okay HarvestBar probably not) Heat can also affect you. If these things don't work, try an anti-diarrheal one hour before the run. Jeff has a lot of people tell him that if the above doesn't work, the anti-diarrheal usually does. 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 of "prerun" 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 and 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. Frederick W. Parker, III, M.D.
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