The question is: “Sometimes during a long run I’ll get really bad
stomach issues, such as cramping, nausea, or a sudden, very urgent need to use the
restroom. What causes this, and what can I do to prevent it?”
اضافة اعلان
For many runners, long or intense bouts of exercise
can lead to a range of digestive issues, such as stomach pain, nausea, and
diarrhea. While gut issues can happen during many endurance sports, experts say
they can be especially problematic for runners and are thought to be caused, in
part, by a lack of blood flow to the intestines. Some call it runner’s gut,
others refer to it as runner’s belly, runner’s trots, or a number of other
names.
So what is runner’s gut, exactly? And what can be
done to avoid it?
What causes runner’s gut?
During a run, when oxygen is
supplied to skeletal muscles, “the blood that is supposed to be flowing to the
intestines is actually going to your muscles”, said Sam Wu, an exercise
scientist at Swinburne University of Technology in Melbourne, Australia.
This shunting of blood to the muscles can negatively
affect digestion, as “you need a lot of blood flow to the gut when you are
digesting food”, said Dr Lauren Borowski, a sports medicine physician at
NYU Langone Health.
This reduced blood flow, combined with physical
jostling, can cause nausea, diarrhea, cramping, or the sudden need to defecate,
especially if you are running on a full stomach, Borowski said. Such symptoms
can be exacerbated if a person is dehydrated, which reduces the overall volume
of blood flowing through the body, or if they have hard-to-digest foods moving
through the digestive tract, such as complex carbohydrates, fiber, or protein.
Without enough blood to aid digestion, the body will pass partially or
incompletely digested foods.
“Things that are not digested are just flowing
through your intestines,” Wu said. “That’s why you have to run to the toilet.”
For long, sustained endurance efforts, such as
running a marathon, the shunting of blood away from the intestines can damage
the thin layer of epithelial cells lining the intestine, which control what
enters the bloodstream. During a long run, a sustained lack of
blood flow can
cause these cells to detach from each other and burst open, spilling their
contents into the bloodstream.
The idea of intestinal damage may sound worrying,
but “for most people, that damage is transient”, said Kate Edwards, a doctoral
student at the University of Tasmania who researches gastrointestinal symptoms
in endurance athletes.
However, Wu noted, it is likely that this intestinal
damage can affect the way nutrients are absorbed during a race, leading to less
available energy, or cause general gut discomfort. In a small study published
in 2021, researchers from Britain found that runners who collapsed during a
marathon tended to have higher blood levels of a marker for intestinal damage
than those who did not collapse, suggesting that gut issues may have
contributed to their collapse.
How to avoid it
Thankfully, there are ways
to avoid runner’s gut, Borowski said. When running long distances, such as when
training for a marathon, you need to eat enough to fuel your body, but not so
much that it causes gut issues, which is tricky. “What to eat and when to eat
is really difficult when it comes to marathon training,” she said.
Two to three hours before a run, eat foods that contain
simple carbohydrates, like bananas, rather than foods with lots of fiber or
complex carbohydrates, such as berries or whole wheat bread.
Training the gut for a long run can be every bit as
important as training your legs. Practice what to eat and drink while training,
and remember that a race will be more intense than most training runs. Pay
special attention to how you feel during training runs done at race pace,
rather than just during long, slow runs.
On race day, anxiety can also contribute to stomach
issues, which is why Borowski advised not putting any extra strain on your gut
and sticking with the usual foods you eat before runs, rather than trying
something different. It is also important to stay hydrated.
One recent study of 46 people concluded that
compression socks may help, too. In the study, published in September in the
Journal of Strength and Conditioning Research, researchers from Australia
looked at the associations between wearing compression socks and intestinal
damage during a marathon. Compression socks, which apply pressure to the
outermost muscles of the legs, are known to improve circulation.
In the study, those who wore compression socks while
running a marathon showed lower levels of a blood marker for intestinal damage
than those who did not. Wearing compression socks may not thwart runner’s gut,
Wu said, but it is a relatively simple action that may help minimize the
effects.
“If we can improve the blood flow and increase circulation
to the deeper parts of the body, then we should be able to promote blood flow
back into our digestive system,” said Wu, who was one of the study authors.
“That can help to decrease or reduce the amount of damage that’s done to our
gut during high-intensity exercise.”
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