You’re in the middle of Comrades when, out of nowhere, your stomach starts to churn. Instead of focusing on crossing the finish line, you’re now worried about just making it there without puking or pooping – or both. And yet, you’re determined to finish this thing. So what should you do?

At one point or another, most runners have been plagued by nausea, vomiting, loose bowel movements or diarrhoea. In fact, one study found that more than 60 percent of distance runners have had to stop mid-run to poop. 

This is often referred to as ‘runner’s stomach’, a kind of catch-all term that represents the many ways your stomach can attempt to sabotage you during a run. You may also hear this referred to as ‘runner’s trots’, thanks to the short, quick steps you’re forced to take when suffering.

Fortunately, there are things you can do to cope with the discomfort. 

What causes Runner’s Stomach and Runner’s Trots?
All that bouncing up and down can actually jostle your organs and push food through your digestive tract faster, explains Dr Peyton Berookim of the Gastroenterology Institute of Southern California. At the same time, some of the blood that normally flows to your intestines is being diverted away, towards your leg muscles. All of these factors can mess with your digestion, and leave you feeling queasy or like you need to find a bathroom right away.

Hormones can also play a role. High-endurance exercise like running signals the release of the stress hormone cortisol, which can contribute to that sensation of having to go, Berookim says. And the anxiety and pressure that can sometimes come with racing only make things worse.

According to both Berookim and dietitian Amy Goodson, the wrong foods and drinks can add fuel to the gastrointestinal fire. High-fibre foods, high-fat foods, spicy foods, foods containing fructose or sugar alcohols, and caffeine can all turn race-day stomach problems into an even bigger deal. So can eating anything within two hours of running.

How to settle your stomach during a race
If you have to battle runner’s trots during a training run, it’s not the end of the world. But when that gurgle in your belly hits mid-race, there’s a lot more to lose. Prevention is really the best medicine in this case (more on that below!), but there are a few things you can do while pounding the pavement to help ease your discomfort.

1. Slow down. Fast running is more likely to mess with your stomach than a gentle jog. “Slowing your pace down allows blood flow to redistribute to your GI tract, and it might help you feel better,” explains Goodson.
2. Sip some water. It might seem counterintuitive, but dehydration can actually lead to diarrhoea, Berookim says. Try to get your hands on some cold water, rather than H20 that’s been sitting out in the sun for a while. “Warm liquids can speed food through the digestive tract,” Berookim explains. And that could make your stomach problems worse.
3. Eat something bland. Sometimes nausea can be the result of an empty stomach. If you didn’t fuel up before the race, or you feel a combo of hunger and nausea, try eating a handful of plain crackers or a bland granola bar, Goodson recommends.
4. Stop and go to the bathroom. That urge to poop probably isn’t going to disappear, and there’s a good chance it’ll get stronger as you keep running. “If you have to go to the bathroom, probably just stop and go,” Goodson says. Sure, it’ll slow you down by a minute or two. But if it helps you feel better, you might be able to make it up and stay on track.
5. Stick with familiar foods. Your pre-race dinner or breakfast isn’t the time to try something new. “Knowing that you’ll naturally be more jittery the morning of the race, practise your pre-run meal just like you practise your run,” Goodson says. “Try a few breakfasts on long-run days and see what works best.” And once you find what works, stick to it.
6. Don’t eat within two hours of racing. Having your pre-race breakfast early means you won’t still have food in your stomach when you actually start running. Give your body enough time to digest before the running starts, even if that means eating something and then going back to sleep.
7. Avoid potential irritants. High-fibre, high-fat, high-fructose and spicy foods, as well as sugar alcohols or sugary drinks, can all send you running to the bathroom; so start steering clear the night before your race, Berookim recommends. If caffeine tends to cause a problem, try to go without your morning coffee.
8. Save pain relievers for after the race. NSAIDs such as ibuprofen can irritate your stomach. 

If you’re still uncomfortable post-race, rehydrate with unsweetened iced ginger or chamomile tea. Both contain compounds that can help reduce nausea, Goodson says.  

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