How to avoid the dreaded runners' trots

·5-min read
runners diarrhea
How to avoid runners' trotsullstein bild - Getty Images

There are hundreds of methods runners experiment with in order to avoid the dreaded runners' diarrhea (aka runners' trots): avoiding coffee pre-run, no fibre the day before, avoiding dairy and ditching spicy food. And the queue for the toilets at the start line attests to the importance runners put on sorting issues pre-run.

But what’s the best way to avoid runners' diarrhea?

Mary Kate Keyes, director of nutrition and wellness for health app MindFirst, has, like all runners, experienced digestive problems first-hand while running. ‘I too often found lower GI upset to be the most stressful part of race day – I’m sweating just thinking about that bargaining you’re doing with yourself: “Do I just hop over to the side of the road now or can I make it home?” Not a club you want to be in.’

So we asked Keyes, along with registered nutritional therapist and owner of Goodness Me Nutrition, Anna Mapson, what causes these gut issues, and what are some ways runners can avoid suffering from bloating, cramps and runner's trots during long runs.

What causes runners' diarrhea?

There are a number of reasons a person could develop runners’ diarrhea, and the jury really is still out on the one true cause (if there is just one).

‘One theory is that our muscles pulling blood away from our GI tract during exercise, combined with the natural lack of blood flow to the organs, causes the colon to “panic”, eliciting diarrhoea,’ says Keyes.

Anna Mapson says that high-intensity exercise can create digestive issues due to the chemical changes in the gut during a workout. ‘Our bodies produce enzymes and cytokines, which can disturb the lining of the gut and allow toxins into the tissues.’ She highlights a study by Clinical Science that showed that endotoxins were released into the bloodstream during ultramarathons, which can trigger the immune system, causing digestive issues.

Another explanation is down to a runners' diet, but to date, no one specific food or food group has been linked to causing the problem, although there are certainly foods that make the issue worse. Energy gels and drinks can famously often result in intestinal distress, especially if that’s the only food you eat during a long run.

There’s also the mental aspect of it. ‘For me, there was a strong mental component,’ says Keyes. ‘I feared I would have diarrhea, and this stress caused me extreme GI discomfort. I found that being more mindful helped with this particular issue.’

How to avoid runners' diarrhea

1.Stick with foods you know don’t cause you problems

The general rule of thumb is to avoid fruit juices, high-fat foods and high-fibre foods the day before a run. ‘Stick to loading up on simple carbs and, of course, hydrate,’ says Keyes. ‘If you do end up with an upset stomach, out-of-the-ordinary cramping or diarrhea on a training run, think back to what you ate before you left the house – was it something you usually don't eat?’

2. Evaluate your stress levels

If you're feeling constantly stressed in your day-to-day life, whether it’s caused by work, home life, financial problems or other issues, it can affect your stomach during running. ‘High-intensity exercise can increase short-term circulating cortisol and adrenaline, and if it's already high through chronic life stress, it may be adding to the urgent need to evacuate,’ says Mapson.

3. Give your gut bacteria some love

‘Gut bacteria living in our intestines is an important part of our digestion,’ says Mapson. ‘It helps us break down fibre, create a healthy colon and produce anti-inflammatory molecules called short-chain fatty acids. Any imbalance of gut bacteria may lead to increased issues with digestion, so it's important to consider whether this is an issue.

‘Long-term, you can encourage healthy, beneficial bacteria through eating a high-fibre diet and increasing the diversity by trying new foods. However, some people are sensitive to fibre and may benefit from a low-fermentable diet in the run-up to a big race or workout to reduce symptoms.’

The low-FODMAP diet was created for people with IBS to remove fermentable carbs and reduce bloating, gas and diarrhea. ‘You could try cutting these foods out for a short while, but the diet isn't meant to be followed long-term because it can starve the gut of bacteria.’

4. Track your food consumption before long runs

Keep a food diary to see what you've been eating before any incidents and if there’s a pattern. This can be useful in identifying foods that don’t agree with your gut when you run. ‘Remember that food normally stays in your digestive system for around 36 hours, so it's unlikely to be the food you ate directly before a run,’ says Mapson.

Doing this can help you identify foods that can be specific to each person. ‘I once worked with an athlete who did her best running after eating almonds, a food that would make others head to the toilet,’ says Keyes.

5. Check gels’ ingredients

If you are particularly prone to issues with gels or energy drinks, Mapson recommends having a close look at the small print. ‘Check any energy supplements you take during your run for alcohol sugars such as xylitol, sorbitol, etc, as these are high-FODMAPs and draw water into the small bowel, which can cause diarrhea in high doses.’

6. Drink caffeine

Keyes says that some experts recommend avoiding caffeine before a long run. ‘I do not recommend this.’ Instead, she advocates having your normal amount of caffeine – no extra and, again, be sure to hydrate with water. ‘If your daily coffee helps move your bowels in the morning it’s a good idea to maintain your bathroom habits and clear that colon before you start your run.’

7. Reach for the Imodium as a last resort

If you’ve analysed your diet and nothing jumps out as to the source of the problems, Keyes says that Imodium can be a useful tool. ‘This is something I have used for long runs and for race day. The drug works by slowing down your GI tract just enough to not cause you extreme bowel distress. Be careful though, use this drug sparingly – too frequently can cause health problems, least of which is constipation.’

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