GI Distress — The Not So Sexy Part of Long Distance Racing & Training (Part 3)

How to Limit Nausea, Vomiting and Diarrhea Mid-Race – Race Day Strategies

The past 2 days and posts we’ve covered causes of GI distress and pre-race strategies to minimize risk for distress on race day. As race day approaches, keep these strategies in mind for the day of your race so that your system is optimally fueled for you and your performance goals!

Race Strategies

  • Hydrate! – Stay hydrated! Drink plenty of fluids! Beware that drinks that have >10% concentration of carbs (sugars) are associated with cramps, diarrhea and nausea. Standard Gatorade is around 6%. Watering it down 1:1 or 1:2 can help sensitive stomachs. Think about this with soft drinks at aid stations. If you want that Coke, make sure to drink a cup of water too, since watered down Coke is nasty!
  • Electrolytes – make sure to consume food or drinks that contain sodium and potassium. A good goal to shoot for with sodium is 250-500mg/hour. What that looks like in terms of food or drink is based on what you eat and drink. Do your research and look at the nutrition labels to see how much sodium is in a serving AND also what a serving size actually is for that item!
  • Meal Timing – your pre-race meal likely should be consumed 2-3 hours before race start so it’s not sitting like a brick in your gut at gun time! Adjust your race day schedule to accommodate for this! If you know in an ultra marathon that you will be taking a break to rest or change clothes, make sure to get a bigger snack prior to that break as it will have some time to digest during the break and while your body is going at a low intensity.
  • “Nothing new on race day!” – If up to 83% of us have GI distress with long distances, don’t choose race day to try a new food or drink! Stick with what you know has worked for you in training!
  • Avoid NSAIDs – Yes, things are going to hurt when you’ve been out there for hours! But beware that naproxen sodium (Aleve), ibuprofen (Motrin), and aspirin can increase GI symptoms, plus they can also delay recovery time. If you really need something for pain, stick with acetaminophen (Tylenol).
  • Avoid excess fat, fiber, protein and dairy products – This applies for both pre-race meals and foods during your race. They take longer to digest, so they will sit in your stomach longer and get jostled around.
  • Avoid acidic foods – eggs, milk, gluten, tomatoes, nuts, coffee, and alcohol. Increasing acid in your gut increases your likelihood of stomach upset.
  • Avoid spicy foods – simple enough!
  • Eat non-acidic foods – bananas, spinach and kale are examples to help balance out the acid that upsets your stomach.
  • “Bites vs. bars” – Consuming small amounts of food at any given time results in less food volume for your gut to digest. Nibble on foods more frequently instead of trying to eat an entire bar at once.
  • Consume food during lower intensity parts of your run so cardiovascular demand isn’t so high – Slowing down to eat so that you don’t puke is much better than pushing on at your race pace and your body forcing you to slow down or stop. Walking through or stopping at aid stations is a good strategy.
  • Avoid concentrated sugars later in a run – unless you’ve trained this way and know that your body can handle it, taking in a straight gel pack in one shot may not end so well for you. Just like with sugary drinks, if you take in sugary foods, make sure to dilute it by getting more water.
  • Take OTC antacid (Tums) – They have a decreased risk of side effects and may help settle a sour stomach.
  • If your system is out of sorts and you’re not feeling well, stick with what you know works for you. Know your “safe” foods that are always well-tolerated and stick with only those.
  • Be aware of sodium content in sports drinks, gels, and chews you typically use vs. what’s on course. A sudden change in sodium load can trigger vomiting or diarrhea. This means you have to do a little research to figure this out, but again, time well spent for all the hours invested in your training and the money invested in your race!
  • Start and stay hydrated – Yes, I’m mentioning it again, because it’s that important! A dry stomach is an upset one.
  • Finally, be prepared! Even if you’ve followed all the tips, you never know what can happen come race day. Toilet paper or wet wipes in a Ziploc bag could save the day for an on-course emergency that strikes!

In summary, have a plan. Execute that plan. Logistics must be part of the plan. Have a plan B. If you made it this far, congratulations! You are now well-armed with the information to help you train and race with success with less likelihood of being derailed by an upset GI system!

Dr. Jeanne Williams, PT, DPT, OCS
We help endurance athletes (from beginners to pros) train and cross the finish line faster and injury-free!

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