Monday, September 22, 2008

Some Thoughts on Stomach Issues

I just finished Rod Bien's race report from Angeles Crest and stomach issues came to mind. It seems that of all the things that bring people down in 100 milers stomach problems (along with blisters and trashed quads) are among the most common.

In my experience stomach problems are capricious and highly unpredictable. One race can go by with no problems at all while the next race things start going down early and the damage is done.

So, I thought I'd throw out a few things I've learned over the years that have helped me and perhaps these might help you as well. However, before I do, I should mention that in my 20 100 mile races over nine years I have experienced nausea in every one and have I experienced vomiting in five out of the twenty 100's. Here are some things that seem to work for me.

1. Regardless of temperature or humidity I begin drinking chicken broth about four hours into the race and continue it throughout. I find for me that the heavy sodium content in chicken broth keeps me from getting sick.

2. If it's hot I try to keep cool by dousing myself with water particularly on my neck, on my wrists and on my stomach.

3. I don't wear anything around my waist.

4. I eat all solid food during the first 50 miles so that the gels taste new and different during the second 50. I usually start with a 600-700 calorie breakfast and then eat something solid every 90 minutes or so. I try to eat going uphill so I can hammer the downhills without a full stomach. I usually eat yogurt, granola, peanut butter and jelly sandwiches, turkey, cheese and avocado sandwiches, pretzels, cookies and Payday Bars. I also try to drink sportsdrink (Gu20, EFS, Cytomax, Succeed Ultra, whatever tastes good) during the first 50 miles to keep the calories flowing and then I usually switch over to all water during the 2nd 50. Once I switch to gels I take them about every thirty minutes although as the race progresses I take them more frequently getting down to about one every 15 minutes for the last hour. Basically, as soon as my stomach feels empty I eat one (sometimes two)

5. If I get a little wave of nausea I take salt, drink a full bottle of water and I try to slow down for about 10 minutes or until the wave of nausea goes away. If I am near an aid station I try to get there and then ask for (and hopefully get) Ginger Ale. For some reason Ginger Ale works very well for me.

6. In the event that I do begin vomiting I attempt to get as much out of my system as possible. It can be pretty gross but I find that if I completely empty my stomach I can begin filling it sooner and faster.

7. After vomiting I usually enjoy a post-vomit feeling of euphoria which allows me to run fast for about 15 minutes. After this fast section I then need to start eating and I try to start with something fatty and salty like chips and then move up to gels if possible. After the 15 minute burst I need to slow down to refill my stomach. If it goes well I can get back on track within 30 mins of the "event."

8. I try to stay as mentally positive during my vomiting episodes as possible. When you stop to think about it it's kind of funny and I find having a positive attitude and saying things like, "Man, that was a full-blown rejection!" helps me forget about how bad I'm feeling. I find that many runners get in a funk after puking so I try to get motivated by it and laugh about it.

9. The most important thing I do, I think, is I always stay hydrated. I know it may sound obvious but in my experience bad things happen when I'm dehydrated. No matter what the temperature I drink 50-60 ounces per hour throughout the race and try to stay on top of hydration above all else. At Western States in 2006 when it was 114 degrees in El Dorado Canyon I drank 120 ounces in one hour!

10. I keep telling myself "It never always gets worse."

16 comments:

Peter Lubbers said...

Great tips!
Thanks for sharing.
Peter

jhalekas said...

Andy,

Great post. Lots of useful tips.

For me 2, 3, and 9 on your list are the big ones. I'm lucky enough to have a pretty strong stomach, but the times I get in trouble are when I get overheated and/or dehydrated. Your body can't be expected to digest anything if it is busy dealing with cooling your body, or if fluids or electrolytes are out of whack.

My strategy is to keep it as simple as possible. Mostly gels, a bite of powerbar here and there just to combat the empty stomach feeling, water to drink, and S-Caps for electrolytes. I think there is lots of room to experiment with what works for you, but I really think the simpler the better. And stick to stuff that you've tried in training. Think twice about shoveling down some random stuff at an aid station if you're not pretty sure it's going to work. Especially stay away from fruit, unless you are dead sure it works for you. Nothing will screw up your stomach more than the fructose in that bite of nice cool watermelon that looked so appealing...

-J

AJW said...

Jasper,

I hear you on the fruit as I've had some trouble with that. However, for some guys it's great. For example, Geoff Roes, this year's Wasatch winner, told me he ate about 5 pounds of watermelon this year at Wasatch. Seemed to work for him. So, once again, we're all different.

Are you running WS in 2009?

AJW

Smarty said...

Andy,

Good stuff, thanks for sharing! I'm new to ultras so your writing is very helpful.

Sophie Speidel said...

Thanks Andy, your tips are very timely as I get ready for Grindstone in 2 weeks. I had serious stomach issues during my first 100 at Massanutten (too much food for my stomach to deal with) and have since switched over to all gels, SE, and chicken broth. I am nervous that I will get lazy in those second 50 miles about fueling and then fall behind...this was a good reminder post.

I enjoy your blog! I also work as a counselor at an independent school, so I enjoy reading about your work and school.

Congrats on your great season!

Rod Bien said...

Andy,
Thanks for the relevant post! Anyway, here are a few of my concerns. Salt.... I rarely if ever train with it (I'm not a big sweater) so I have figured "should I really start taking a shitload of salt just cause it is a race?". I was pretty consistent with my salt during the first half of the race but did just take one S Cap per hour......
Yeah, the gels just seem to sour me by the second half of a 100 mile race. Has anyone had experience with Carboom? That actually sounds like a good idea with all the calories and theoretically it is tasteless???? Lastly, I think to some extent, some peoples' systems just seem to "freak out" more than others. Not an excuse but some people just seem to have iron guts (Jeff Browning, etc) and others seem to battle with it all the time (me, Ty Draney, Meissner). I'm smart enough to know that it isn't just a "toughness" but seems to be a REAL reaction either to the products we are putting in our body or just the stress of the event. btw, I have never puked on any race less than a 100 or on any training run of any distance. Just seems to be uniquely in 100s. Anyway, we'll chat about this later but just thought I would throw down some thoughts while they are fresh in my head. Thanks for all the advice going into AC. I also know I need to keep things in perspective. 21:14 at AC isn't the end of the world.....
Aloha,
Rod B.

jhalekas said...

5 lbs of watermelon!? That would make me sick even if I was just sitting on the couch. Well, experiment of one, eh?

I've got my WS2009 entry sitting on my desk at home. Just have to fill it out and send it in. I must admit that I have a lot of mixed feelings about this race, but I intend to toe the line. Look me up if you come down to train on the course - I hope to be out there a lot next spring.

-J

P.S. To Rod - personally I think Carboom is pretty gross. But the Carboom I had was definitely flavored.

lc said...

Invaluable advice, AJW. Thanks so much for sharing, yo!
lc

Bedrock said...

Thanks for the tips Andy. Just curious, do you ever use shot blocks (or similar)? I have used them on training runs but never tried in a race. Seems like they might work well.

Anonymous said...

AJizzleWizzle,

Useful post, but you didn't mention beer at all. I thought your pre-race beer ritual was part of the strategy.

How many do you drink the night before a 100?

LB

Derrick said...

Great post Andy. Thanks for that. Just finished my first 100 and my stomach was a concern for me going into it. Ended up going well, but did it on pretty much all liquid (gels, bloks, drink) with a little melon and bananas. The solid food appeals to me in theory and I might take your advice about it in the early going next time.
Congrats on your season.
Derrick

Charlie Mercer said...

Everyone has to have a niche in the ultrarunning community. I think Rod just wants to be sponsored by the SourStomach racing team. Eligibility requirements: (1) Be nauseated in your first 20 100 milers; (2) Win at least 3 of those 100 milers; 3) Laugh whenever you hurl prodigiously; (4) Publish advice via top ten lists; (5) Bring a toothbrush on all ultras.

Thomas Bussiere said...

Thanks Andy for the food advise. This was a problem for me at Vermont this year. I'm going to try what works for you on a few training runs before going into the Pinhoti 100 this Nov. Great job at VT this year.

Geoff said...

the 5 pounds was a bit of an exxageration i'm sure, but i did eat some watermelon at every single aid station that had it. I don't know if i have ever passed through any aid station in any race and not eaten at least one piece of watermelon if it was there... and i've never once vomited during a race (although i did vomit after the wasatch). watermelon just always tastes so good and goes down so smooth.

i think more than anything our bodies and minds tell us what we need and what will work. if your body craves something it will likely accept it and if you force down something that sounds horrible at the time your body will likely reject it.

Anonymous said...

MR. HALEKAS

https://www.blogger.com/comment.g?blogID=451222917425507533&postID=295420373268212006

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