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Runners Gut

It’s just a jump to the left, and a step to the right. With your hands on your hips, you bring you knees in tight…

Not an iconic dance move, but a familiar dash for a bush, tree or large rock. Runner’s Gut is one of the many reasons that lifelong friendships happen out there on the trails. Any regular training partners eventually get around to discussing Tummy Trouble, and with that kind of truth between you, its friends forever.

The pre-race toilet rituals, the White Gold (bog roll) in a Ziplock bag, and if you haven’t experienced some kind of mid-race bloating or emergency bush dive somewhere along the line, count yourself very, very lucky. For the rest of us, is there any way to escape the inevitable, particularly when it begins to encroach on your running joy?

We interviewed Ann Ashworth, an elite runner (Comrades winner), Team Manager and Coach, and full-time advocate in case you thought she was lazing about in between huge training blocks! Ann, now based in KZN, has had her fair share of digestive issues, through which she has happened upon certain tricks and wisdom.

“Between April 2017 and June 2019 I experienced chronic IBS-type symptoms - gas, bloating, cramping which proved particularly problematic in the afternoon (compromising my afternoon training, especially if it was a speed or quality session) and during long runs. Depending on what I ate post-breakfast, I could be too bloated and sore to run hard in the afternoon and was sometimes restricted to running on the treadmill at home in case I needed quick access to the loo. On long runs I’d regularly be in and out of the bushes with gas and diarrhoea. It was particularly bad during the second half of Comrades in 2019 when, from about 50km I started hitting the bushes every 5km. Initially I thought I was suffering from a gluten intolerance, then IBS… but I’ve subsequently come to learn that my gut distress was symptomatic of Relative Energy Deficiency Syndrome (RED-S), a condition associated with chronic low energy availability (where you don’t eat enough to sustain your training load, either because your training load is too high or your diet does not have sufficient quantities of the nutrients your require to function effectively).”

Ann has since aligned with a new coach and come back spectacularly, despite seemingly insurmountable setbacks which included a spinal fracture. Her current form placed her second in the recent virtual Cape Town Marathon, where she ran under 2h42min with a telling smile firmly in place. Through her own challenges, Ann has worked out some basics to assist anyone battling with IBS or a similar infliction. Prevention is king.

  1. A healthy gut is a happy gut - it’s important to maintain healthy bacteria in your gut as these bacteria help you to breakdown and absorb the nutrients you need from food. When your gut bacteria go out of balance, this can cause things like sugar cravings, bloating, gut distress and the like. I use yoghurt, kombucha, Maas and sourdough bread to maintain a healthy balance.
  2. Check what is in your gels - highly engineered gels such as those containing a high proportion of maltodextrin can cause gut distress when racing and training. Fuel instead with gels containing simple, natural sugars such as glucose and fructose or, better yet, eat fruit, potatoes, and honey to keep your energy levels up rather than artificial sugars and highly refined products.
  3. Limit your bread intake to 3 times a week and skip the highly refined stuff like cakes, muffins, sweet loaves, and the like.
  4. Try to do your quality session in the morning, leaving you free to eat freely the rest of the day without worrying about gut distress during training in the afternoon.  

And if your Tummy Troubles hit mid-run, or mid-race? Best to listen to the force of nature and find a suitable tree, bush or rock as soon as trouble starts. Fellow runners know your plight, so don’t let the embarrassment obliterate your run. Carry biodegradable wipes or bog roll in your pack as part of your standard trail gear. Hydrate swiftly, as dehydration can cause or exacerbate bowel irritation. And nibble on bland, salty foods for a few kilometres afterwards. Crackers work wonders.

It happens to the best of us.

Words: Kim Stephens