Toilet Training[from the English running magazine Today's Runner]
A delicate subject that some runners find a little difficult to stomach
Diarrhoea : a hard word to spell but the easiest condition to suffer from during a long race. Until this year's London Marathon which with all due respect to Flora would have been better off being sponsored by Diocaim, race reports made vague references to leading competitors succumbing to stomach cramps', 'a bad stitch' and other such euphemisms. We all saw Joyce Cbepchumba chuck up her breakfast the instant she won the 1997 London, but what we might call the other evacuation route was never mentioned until this year.
And then along came Catherina McKiernan, following the yellow painted line at the side of the road rather than the blue line. This wasn't because she wanted to run further or shorter than the 26 miles and 385 yards, but because the TV cameras covering the leaders were positioned close to that blue line, ready to beam close-up images around the globe.
These would have revealed that Catherina had indeed suffered mightily from stomach cramps, a bad stitch and whatever else you wish to call it. She'd suffered from them four times around the course, and then again at the finish when she vainly sought the nearest portable toilet to the freshly broken tape. "Ireland's Catherina McKiernan defied the winds to record her second successive marathon victory" proclaimed Athletics Weekly - how right they were.
Increased bowel activity brought about by long-distance running doesn't discriminate between the plodders and the fleet of foot. Richard Nerurkar, in the form of his life, was lying in bronze medal position in the final quarter of the Atlanta Olympic marathon, until a toilet stop knocked him back to fifth. Grete Waitz had so much trouble in the New York marathon one year that one wag suggested that her name should henceforth be used as rhyming slang.
You'd expect the fellows dressed as orang-utans, who accept all the toffees, oranges, fizzy pop and chocolate biscuits offered by well-meaning spectators to have gastrointestinal problems. Ditto those who've only done a bit of training and in the final days before the race have suddenly heard about carbo-loading. They eat far too much in too short a period, ladling the pasta onto their plates, and their run is wrecked by the runs. This surely shouldn't happen to the elite, though. They've the benefit of decades of sports science and nutritional research to fall back on. Sadly, the marathon is a merciless taskmaster, and at some stage, everyone gets a slap in the face.
Steve Brace, a veteran of over 50 marathons, has been there. "The law of averages says it's bound to have happened to me a few times. In the Houston marathon one year it cost me dear. From as early as seven miles in I was in trouble. I'd been in the invited athletes' lounge beforehand for breakfast, and I'd had a slice of brown toast. That did it. My toilet stop was quite late in the race, and I would've stopped earlier but it was a highly residential area, and you end up panicking and thinking 'whose garden can I go in?' My laces came undone at 22 miles which didn't help either. In the end, I did 2:10:35 and missed out on winning by one second."
The Godfather of British distance running, Dr Ron Hill, has had to answer the call of nature on a number of occasions over the years. "I remember one night when I was out training, and I had to go in a ditch. A car suddenly appeared and I hardly had time to get my shorts up!" Then there was the time during a major championships when he had to make use of a cornfield. Unfortunately, harvesting had been carried out the week before, so the only cover he had was a few stalks. "A lot of my friends saw me stop on TV. With some people it may be nerves that affects them, but with me I believe it was always a dietary factor that caused it."
One elite athlete who ran into trouble was Nadezhda Ilyina at last year's LA marathon. She needed to stop at 22 miles, choosing, appropriately enough, a gas station. She rejoined the race and actually went on to win. Unfortunately, it later transpired that stop resulted in her chopping just 30m from the course and the organisers subsequently had to disqualify her, costing her the $41,000 first prize.
Catherina's overcoming her problems to win suggests that you can come through, if not smelling of roses, then cenainly in a good time. Steve Jones did precisely that in setting his London course record, which endured until last year's race. Understandably, the runner-up Charlie Spedding was reluctant to shake Steve's hand at the finish.
So you can take a break and still come up trumps, so to speak. There are some who plan ahead, though, and expect the worst. Bruce Fordyce, guru of ultra-distance running, is the multiple winner of the 56-mile Comrades Marathon in South Africa. For long runs he inserts various sponges into his shorts.
The answer, you may think, is to compete at shorter distances. Not necessarily. Britain's only track medallist at the Montreal Olympics of 1976 was Brendan Foster, whose bronze in the 10,000m behind Lasse Viren and Carlos Lopes was an excellent feat. Who knows, though, how much better he might have done had he not been suffering from symptoms so familiar to Brace, Hill, McKiernan et al. When he returned to the UK after the Games, he reportedly told a training partner that during the closing stages he didn't know whether to sprint and, as Frank Spencer would put it, do a woopsy, or keep to a slower but safer pace.
Bear in mind, there aren't too many portable toilets lining the route of a track race. "At least in the marathon," one top 20 placer told me, "you can have a pit stop. At least that's what I think he said.
If you suffer from runner's trots, you are not alone. It's estimated that about 30 to 50 per cent of all endurance athletes are afflicted by some form of upper or lower gastrointestinal disturbance.
The main cause of gut problems is thought to be the increased jolting, bouncing and mixing of food caused by the running action, coupled with a decrease in blood supply to the intestine during exercise. Women are thought to suffer more than men (although no one knows why), while many runners mistakenly reduce the amount they drink before and during exercise to try and prevent stomach problems. In fact, you're more likely to suffer if you become dehydrated.
Other factors which can cause diarrhoea or gut problems are:
- specific food intolerance, the most common being to lactose (milk and dairy products). Other potential intolerances are glucose, fruit and wheat products
- excessive use of anti-inflammatory drugs
- sudden, extreme increases in training volume or intensity
- gastrointestinal disturbances are also less frequent after adequate training and when exercising at a lower intensity.
So if you are having gut problems, you need to look at what and when you eat. This is a very personal thing as what works for one runner is unlikely to work for someone else - we all know someone who can run with no problems straight after eating a fry-up, while others can't run within three hours of eating anything.
Other factors you need to consider are:
- the type of exercise - most people find it easier to bike straight after eating than run
- how hard you will be working -normally the more intense the session, the longer you should leave between food and exercise
- how nervous you are - increased nerves = increased stomach churning!
It's really a case of trial and error to find what works for you and in the case of racing make sure you try your race routine in practice. This does not just mean the obvious ones like pre-race dinner and breakfast and what energy drink you will use during the race, but also getting your body used to running at race time. For most people bowel movement is pretty regular time-wise, and is linked into your normal routine. If you suddenly get up two hours earlier than normal, are feeling nervous and then start running earlier than you ever do in training, is it surprising that sometimes your gut gets thrown into confusion?
To reduce the risk:
- try eliminating suspect foods and then slowly re-introduce them to your diet
- increase the time between eating and training
- limit your intake of gas-forming foods - broccoli, onions, beans
- limit your intake of fibre-rich foods - eat white bread and rice
- avoid coffee and other caffeine
- experiment with liquid meals before races
- never try a new supplement or drink for the first time in a race
- increase your training volume and intensity steadily, not in ex-treme jumps
- don't take large doses of vitamin C, sodium bicarbonate or carbo drinks before races or during exercise
- keep well hydrated, and get used to drinking during training
- try to go to the toilet before you exercise.
And if none of that helps, ask your GP for a gastroenterological examination to ensure that nothing untoward is wrong - and always plan your runs to go past plenty of toilets, garages and big bushes.
Happy running - and don't forget the toilet paper.