IBS and Exercise: How Should Runners Cope?

Running with irritable bowel syndrome or IBS can be challenging. Many things contribute to IBS on a run, but there are also tactics to help make it manageable to continue training with some semblance of normalcy.

What is IBS?

Irritable bowel syndrome is a functional gastrointestinal disorder impacting the colon. People living with IBS experience diarrhea, bloating, constipation, and cramping. Many people live with IBS and manage symptoms with dietary modifications.

For unknown reasons, twice as many women as men are impacted by IBS. Although IBS does not appear to be stress-related, many people experience their first IBS flare-up during a particularly stressful time in their life.

Scientists say that foods do not cause IBS; however, it is widely accepted that some foods are more likely to trigger flareups than others.

Managing IBS

Moderate Instead of High Intensity

Athletes who engage in high-intensity interval training (HIIT) tend to see a stronger onset of IBS symptoms and problems. Also, distance runners experience similar issues when training hard or long.

One compromise is to train with moderate instead of high intensity to help alleviate those problems. Think, “more is not always better” for living with IBS.

Practical Tips

1. Avoid fatty or gas-producing foods before exercise
2. Avoid caffeine or hot beverages before working out
3. Eat as little as possible (or not at all) two hours before workouts
4. Limit fiber intake for up to 2 days before the long run or race
5. Hydrate, hydrate, hydrate (IBS symptoms can worsen due to dehydration)
6. Avoid artificial sweeteners
7. Nothing new on race day! This includes gels, blocks, and other nutrition commonly offered on the racecourse.
8. Over-the-counter antidiarrheal medicine
9. Take a daily probiotic 

Medication

Sometimes a doctor will prescribe antispasmodics to help control the abdominal spasms. In addition, antidiarrheals can be used to end diarrhea.  Typically, people who have IBS issues outside of exercise will resort to medication to improve the quality of life.

Others only have IBS symptoms when exercising. These athletes often prefer to follow a more holistic approach.

Running as Curse and Cure

For runners with constipation primary IBS problems, running can actually help. It has been known to relax the bowel and produce much-needed bowel movements.

For runners with diarrhea, however, running typically exacerbates the problem.  The physical stress of running and the psychological stress of worrying about having to dash to the bathroom often combine to create the perfect storm. And make no mistake..it’s a crap storm of epic proportion.

Low FODMAP Diet Helps Some People

A low FODMAP diet can help many people suffering from IBS. What are FODMAPs? FODMAP stands for fermentable oligo-, di-, monosaccharides, and polyols.

These are the scientific terms used to classify groups of carbs known for triggering gastro distress symptoms such as bloating, gas, diarrhea, and/or constipation. FODMAPs are found in a wide range of foods in varying amounts.

The key to following a low FODMAP diet is diligence. You must be super careful during the elimination phase and add items back one at a time to see which ones trigger a negative digestive response.

More Distance, More Trots

There is a common phrase in marathoners, and that is the “twenty mile trots.” That is because it is so common for that to be a point of gastro contention.

Truth be told, though, the trots come at different points and distances for all runners. Personally? The 8-mile mark seems to be where disaster strikes for me as a runner.

According to Dr. Schnoll-Sussman, between 20-50% of all runners experience some gastro distress during a 10K race. The runner’s trot encompasses everything from nausea and painful cramping to gas and diarrhea. The urgent need to poop usually follows, which can be experienced during or after the race.

Advice Specific To Runners

Carry Toilet Paper

Yup. You read that correctly. You never know when an emergency might strike, so you best be prepared. There are many types of running belts to help you carry items you might need in the event of a “crappy run.”

Hydrate

When exercising for long periods of time, you need to take in hydration long before you feel thirsty. This often means carrying your own hydration for long runs.  These come in many different forms, such as backpack hydration packs, hydration vests, hand-held water bottles, and hydration belts.

Fuel That Agrees With Your Stomach

When choosing your fuel for the long run, it is good to go with easy items on your stomach. The only way to determine if a product works for you is through trial and error. I am fond of Honey Stinger Waffles, which are made from real ingredients.  When marathon training, I also found success with Clif bars.

It is important to remember that fuel is not a one-size-fits-all.

Know Your Routes

A common consensus among runners with IBS is knowing your route and planning to run near restrooms around your “witching hour.” When marathon training, that only time I got bit by the marathon bug; I ran an 8-mile loop then ran in a 3-mile loop “through town,” so I was always near a restroom. When I shared that with a friend, she exclaimed, “How boring!”

It may be boring, but it beats crapping your pants!

Over-the-counter Anti-diarrhea Medication for Long Runs

Although physicians will tell you not to consistently use any type of anti-diarrhea medication, any runner will tell you that, if you suffer from IBS, using one of these for a long run and/or race can be life-saving.

In my women’s online running group Sub-30 Club, most women who frequently experience IBS take a drug like Imodium at least a couple of times a month during high mileage training.

Daily Probiotic

The jury is still out on the daily probiotic as a cure for IBS, but many runners favor this. In addition, creating better “gut health” often helps with IBS symptoms by facilitating a more regular pooping schedule. Yes. I said, pooping.

How Bad Does It Get?

If you’re asking yourself, “Is it really that big of a problem?” The answer is YES!

Have you ever heard of the one sock club? That’s what happens when you have to emergency poop in the woods and wipe with your sock.

One runner spoke about wiping with leaves and quick googling “What does poison ivy look like?” on her phone before doing so.

I have had to cut more runs short than I care to admit. Also, when I head out for the long run, I tell my husband to turn the volume up on his phone, just in case I need to be rescued. More than once, he has had to come to save me.

As any spouse of a distance runner can tell you, it is common to ask, “How was your run?”

If I answer, “It was a shitty run,” my husband knows that does not mean I ran badly, it means something else entirely. So yes, the pun is intentional.