Runner’s Diarrhea: Why You Get It & How to Prevent It

Runner's diarrhea affects long-distance runners during and after a run. While the cause of the condition is unknown, there are ways to manage it. Read on to find out how.

Runner’s diarrhea, also known as runner’s trots or colitis, is a gastrointestinal condition that affects runners, most often long-distance runners, during and after a run. Also known as runner’s trot, this unwanted gift of nature causes you to experience frequent bowel movements during your runs. There’s nothing quite like the fear of an unpleasant accident to make training less fun. Unfortunately, doctors aren’t sure what causes this condition, which affects around 60% of long-distance runners, except the exercise itself. However, there are ways to manage it and not let it impact your performance on race day.

There are other possible symptoms you may experience other than the sudden and urgent need to use the toilet, including:

• flatulence
• heartburn
• nausea
• cramps

These can be experienced during or after a run. These symptoms can start during your workout and last for hours after you finish running. It shouldn’t last more than 24 hours.

Also read: What Should You Eat (And What Not) When You Have Diarrhea

What Causes Runner's Diarrhea?

What causes runner’s diarrhea? The answer is likely multifactorial. There are many theories and various explanations, but the jury is still out on the true cause.

1. Dehydration will make everything worse if your body is already suffering from any of these other issues, as it will affect your performance and your ability to absorb vital vitamins and minerals. Your stomach is left with only one option: to flush out everything. For this reason, dehydration is one of the most common causes of diarrhea in distance runners. While running, try to drink eight ounces of water every 15 to 20 minutes. 
2. The physical impact of running can stir the bowels, which causes the flow of stool production to be sped up. The movement of running in our GI tract can also cause an increase in flatus and other symptoms. High-intensity exercise may also disturb the lining of the gut and our bodies’ production of cytokines and enzymes. In fact, many doctors recommend regular exercise to chronically constipated patients because of this.
3. Blood flow to the intestines is sometimes reduced when you run and the colon “panics”. This is due to blood flow being diverted away from the intestines, and into other parts of the body, such as the muscles of the legs. The gastrointestinal system is sensitive, and weak blood flow can cause the colon to lose its ability to absorb vitamins and minerals, resulting in loose stools. 
4. Another explanation for the problem which is often cited is diet, but no one specific food or food group has been linked to causing the problem. Generally speaking, poor food choices before running usually lead to negative side effects. 
5. There is also the psychological aspect. Stressing about a race or even about runner’s trot itself can make you feel like you’re about to have GI difficulties. Being aware of this may help with this issue.

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Other possible causes include:

• Workouts and regimes that are unrelated to running
• Medicines designed to enhance performance
• Some medications
• Anxiety and stress
• Underlying bowel issues, such as irritable bowel syndrome (IBS)
• Hormonal fluctuations

Dietary Changes to Prevent Runner's Diarrhea

Now you know what they are and what we suspect causes them, you don’t need to worry if you are suffering from runner’s trots! We’ve gathered some top tips to help you avoid or resolve them once they start and get you back to feeling good in no time. You might not like it, but running-induced diarrhea is normal and is rarely a cause for concern. That being said, know when to go to the doctor. These are only tips and tricks and are not a replacement for medical intervention. 

The majority of the following treatments relate to your diet, particularly what you choose to eat in the hours and days prior to a long run. A few general rules of thumb include sticking to foods you know do not cause you problems, avoiding eating an hour or two before a run, and spacing out your runs from your meals. 

Side stitches and nausea can also be alleviated with the help of most of the following diet tips: 

1. Limit high-fiber foods and fruit juices one day before a race, but don’t cut out fiber completely. Try experimenting with different levels of fiber to find one you can tolerate. Alternatively, try sticking to more refined sources of fiber as they are easier to digest than whole grain. Otherwise, try eating those foods after you run.
2. Avoid consuming high-fat foods three to six hours before running as it takes your body a long time to digest fats. It’s even possible that a high-fat dinner from a day prior could still be in your gut. In general, stick to loading up on simple carbs.
3. Limit your intake of sugar substitutes before you run. Ice cream, sugar-free candy, and gum use sweeteners that can’t be absorbed by the body, so they linger in your system, attracting bacteria. Your body pushes them out, and they end up pulling water with them causing osmotic diarrhea. Avoid them at least one day before running.
4. Be careful when consuming energy bars and gels. Have a close look at the small print and check the ingredients of any energy supplements for alcohol sugars such as xylitol, sorbitol, etc. Look to superfoods for natural, energy-boosting alternatives.
5. Get consistent with going first thing in the morning. If this is a struggle for you, try taking probiotics or digestive enzymes. Science also shows that a normal amount of coffee and some water can help to get your body moving. However, that may not be the case for everyone.
6. Cut out dairy and eggs. Although sometimes embarrassing, lactose intolerance affects a large portion of the global population, and you might be one of them! To be on the safe side, try switching to lactose-free products before you run. In fact, many people report that their energy levels go up when cutting out eggs and dairy. 
7. Keep a food journal to help you figure out what your best and worst running foods are. It’s unlikely that the food you ate directly before a run will impact your performance since food normally stays in your digestive system for around 36 hours. 
8. Avoid over-the-counter medications and painkillers such as Ibuprofen, Motrin, and Naproxen. Studies have shown that they can cause more issues for the intestines. In the long term, ice baths, cold water swimming, and foam rollers are better for treating running pains than loading up on drugs.

Read more: Does Fruit Have Protein? 12 High-Protein Fruits

Other Ways to Manage Runner's Trots

Other than your diet, there are several other courses of action you can take:

1. Slow down if you feel the urge to poop. It will give you more control if you slow down or stop running. If you take a break, you will be able to resume running. Try to reduce the intensity or distance of your runs until the diarrhea improves. You could also try slow jogging as an alternative form of exercise for a while.
2. Give your body time to adjust if you are new to running. It is worth being patient because often the symptoms will go away or get better after you have been running for a while.
3. Reduce/Ease Anxiety. Running causes the release of hormones, particularly cortisol, which can make you want to go. Pressure on race day can add a whole new element to it. It’s important to have a routine and process that helps you to manage your nerves appropriately on race day.  
4. Consider what you wear while you run, as clothing that is too tight around the midsection can make your symptoms worse by causing blood to flow to the intestines. Try wearing loose-fitting clothing when you run.

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When to See a Doctor

Runner’s diarrhea that lasts more than 24 hours may be a sign of another medical condition, and you should get a health check-up from your doctor. In particular, if you’re experiencing diarrhea and the loose bowel movements won’t stop, it may be indicative of some other medical condition. It’s time to see a doctor if:

• You’re experiencing diarrhea quite often, even when you’re not running
• There’s blood in your stool
• You have pain in your abdomen or are experiencing a fever
• The diarrhea has come on without any particular change in your running habits or diet
• You feel dizzy, or have fainted or experienced loss of consciousness

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