II. Incidence

  1. Runners Diarrhea affects 35% of runners in 10k race

III. Mechanism

  1. Increased intestinal motility with intense Running
  2. Caused by gastrointestinal peptide
  3. Possibly related to bowel ischemia

IV. 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

V. 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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