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."