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Runner's DiarrheaAka: Runner's Trots

Incidence
1. Runners Diarrhea affects 35% of runners in 10k race
Mechanism
1. Increased intestinal motility with intense Running
2. Caused by gastrointestinal peptide
3. Possibly related to bowel ischemia
Symptoms and Signs
1. Watery Diarrhea
  1. Increased stool frequency
  2. Large volumes
2. Bloody stool in 12% of patients
3. Diffuse nonlocalized low Abdominal Pain
4. Tenesmus
Recommendations
1. Establish pre-run ritual
2. Avoid eating 2 to 3 hours before Running
3. Decrease dietary sugars
  1. Lactose
  2. Fructose
  3. Aspartame (Nutri-sweet)
  4. Sorbitol
4. Decrease Dietary Fiber or use liquid meals before race
5. Decrease caffeine intake
6. Avoid mints or gum containing Sorbitol
7. Avoid large Vitamin Doses (especially Vitamin C)
8. Switch training time of day to evening
9. Stay conditioned
10. Consider anti-Diarrheal drugs
11. Consider temporary decrease in miles or intensity
  1. Initially decrease program by 20-25%
  2. Slowly re-increase Exercise program
12. Consider rice-based electrolyte solution (CeraSport)
  1. Anecdotal evidence only

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.