Pain Relief

Solutions for Exercise-Related Stomach Problems

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When Exercise Causes Stomach Problems
Of the more glamorous things you can do in a day, exercise probably isn’t one of them. The farmer’s blow, the turn and spit, the squat and pee — we’ve been there too. Spend enough time running, biking, or hiking in the great outdoors and you learn to get comfortable with bodily functions not discussed in polite conversation. But no matter how seasoned you may be, coming to terms with a queasy stomach isn’t easy. Those who’ve dashed for the Porta Potty midrace or sprinted to the ladies’ room during Spinning class know what we mean.

If it’s any consolation, you’re not alone. A recent study found that up to 50 percent of athletes deal with GI problems. Other experts put the number even higher. “About 95 percent of my clients experience some GI problem over the course of their career,” says Krista Austin, PhD, a coach and founder of Performance and Nutrition Coaching in Colorado Springs. The most frequent symptoms read like a Pepto-Bismol jingle: nausea, heartburn, indigestion, and diarrhea.

Women are more likely to experience tummy troubles during a workout than men are; hormones may be to blame. “Out of the 25,000 patients we see each year, 60 percent are women, and they outnumber men in diagnoses of functional GI disorders, like irritable bowel syndrome,” says gastroenterologist J. Thomas LaMont, MD, a professor of medicine at Harvard Medical School. “Exercise, especially running, tends to bring out symptoms.” And though gastrointestinal distress isn’t usually a health threat, embarrassing symptoms can prevent women from getting help and discourage them from exercising altogether.

Here’s how it happens: When you begin your workout, the muscles you’re relying on most — your quads during a run, for example — compete with your internal organs for blood. Your organs need blood for digestion; your muscles need it for strength as you exercise. Because the energy demands of your quads are greater, your organs lose out and your body directs up to 80 percent of its blood flow to your legs. In turn, the gastrointestinal system is left with fewer resources with which to digest the food and water you’ve taken in before or during your workout.

Which is why, 20 minutes into your run, that pizza you ate at lunch may pay a follow-up visit. “Some people can exercise comfortably after wolfing down a meal 15 minutes before a workout. Others can’t eat anything within two hours or they’ll feel bloated and sluggish,” says Bob Murray, PhD, founder of Sports Science Insights, a consulting group that specializes in exercise science and sports nutrition in Fox River Grove, Illinois.

The greater your workout’s intensity, the more blood your body will direct away from your digestive system and to your muscles, so you’re at higher risk for stomach cramps in a 10K race than on an easy afternoon jog. But even during tough workouts, there are ways to manage uncomfortable gut reactions. The key is to know which side effects are apt to accompany your favorite fitness activity and practice these smart strategies to minimize them.

Stomach Problems for Runners

  • Icky issues
    Abdominal cramping, diarrhea, side stitches
  • What’s the deal?
    All that pavement pounding jostles the gastrointestinal tract and its contents, triggering lower GI problems. In a 2008 study of more than 1,200 runners in a long-distance race, 45 percent reported problems like cramping and diarrhea during the event. Side stitches, the bane of beginner runners, are caused partly by “gravity and the natural movement of running, which strains connective tissues in the abdomen,” Murray says.
  • Fix it fast
    To redirect blood to your gut, slow your pace until your heart rate decreases to a comfortable level. For side stitches, change your stride, slow down, or twist your torso gently in the direction opposite your side ache. A true emergency? Find the nearest Porta Potty or big tree. Trust us, you won’t be the first or the last to do so.
  • Prevent it
    Hydrate. Drink four to six ounces of fluid every 15 to 20 minutes during your workout, alternating between water and sports drinks for longer sessions to replenish electrolytes, says Ilana Katz, RD, a sports nutritionist in Atlanta.
    Ditch the soda. Cola is a popular pre-race drink thanks to the stimulating effects of its caffeine and sugar. But carbonated air bubbles cause bloating, Katz says.
    Dodge the fat. Nix fatty meals a full day before a big workout, because fat and fiber are digested more slowly than carbs or protein. Also, foods containing lactose (dairy), sorbitol (sugarless gum), and caffeine activate the GI tract. Avoid them starting four hours before your run, says Kevin Burroughs, MD, a sports medicine doctor in Concord, North Carolina.

Stomach Problems for Bikers

  • Icky issues
    Acid reflux, indigestion
  • What’s the deal?
    Up to 67 percent of athletes get acid reflux, compared with about 10 percent of the general population, a Polish study reports. It’s common in cyclists because of their forward-leaning riding position, which increases pressure on the abdomen and can direct stomach acid back up the esophagus, says Carol L. Otis, MD, a sports medicine physician in Portland, Oregon.
  • Fix it fast
    Switch your position so that you sit more upright in the saddle. If possible, take a short break during your ride and walk for a few minutes. Stop eating and drinking until symptoms subside.
  • Prevent it
    Be proactive. Before you hit the road, consider taking an OTC antacid, like Maalox or Mylanta, especially if you’re prone to reflux. “The medicine protects the esophagus with a thin coating, lessening the burn if you have reflux problems while biking,” Dr. Otis says.
    Perfect your posture. Keeping your upper back flat instead of hunching over your handlebars decreases the pressure on your abs, Dr. Burroughs says. And make sure your seat is adjusted for your height: Too high or too low will alter your posture, increasing tension in the abdomen, leading to reflux.
    Eat less. Energy bars and similar foods make easy snacks while cycling, but some bikers bite off more than their stomachs can comfortably handle. For rides of less than an hour, skip the snacks. More than 60 minutes? Consume 200 to 300 calories of simple carbs, like sports drinks, gels, and bars, during each hour to help keep muscles fueled.

Stomach Problems for Swimmers

  • Icky issues
    Abdominal cramping, belching, bloating, nausea
  • What’s the deal?
    “Some swimmers hold their breath without exhaling while their faces are underwater. This means that when they turn their heads to breathe, they have to exhale and inhale at the same time, which causes them to gulp and swallow air and water,” says Mike Norman, cofounder of Chicago Endurance Sports, who trains swimmers and triathletes. A stomach full of air can lead to bloating; gulping water during saltwater swims can cause abdominal cramping.
  • Fix it fast
    Most cramping and bloating occur during belly-down strokes (breast and freestyle), so flip onto your back and ease the pace until the pain sudsides. Also try treading water for a few minutes to keep your mouth above the surface, Norman suggests.
  • Prevent it
    Breathe better. Proper technique helps you access oxygen with less effort. You can dodge waves — and your competitors — by learning to breathe on both sides. When you turn your head to breathe, try looking under your armpit, not forward, to avoid getting a mouthful of water. Slowly exhale through your mouth when you return your face to the water.
    Wear a cap. In an open-water swim, choppy, cold waters can cause disorientation and nausea. Using a swim cap or earplugs can help with balance problems.

Strength Training Stomach Problems

  • Icky issues
    Acid reflux, indigestion
  • What’s the deal?
    “Bearing down to lift a weight while holding your breath, which people often do during strength training, increases pressure on the stomach contents and can force acid up into the esophagus,” Dr. Otis says. That leads to heartburn and indigestion. In fact, people who lift weights experience more reflux than those who engage in other sports, even cycling, according to research published in the journal Medicine & Science in Sports & Exercise.
  • Fix it fast
    Pop an antacid midworkout. Drinking water will also help wash acid south.
  • Prevent it
    Focus on form. Practice exhaling as you contract your muscles to lift the weight and inhaling as you release for each rep.
    Sleep on a slant. Propping your head atop two pillows when you go to bed at night encourages acid to stay in the stomach. (Stick with one pillow if you’re prone to back problems.)
    Eat earlier. For some women, last night’s dinner may appear as tomorrow morning’s workout heartburn. Digestion slows during sleep, so it’s better to eat dinner four hours or more before bedtime.
    Avoid trigger foods. Cut back on reflux aggravators, like chocolate, citrus, coffee, peppermint, and onions.

Natural Stomach Soothers
These herbs can take the edge off workout-induced tummy upset. You can find them in capsule form at your health food store, but the simplest way to get your daily dose is to drink them in a tea.

  • For gas and heartburn:
    Try chamomile. This pre-bedtime beverage may be a powerful anti-inflammatory. A cup of chamomile tea is used to soothe and calm the entire digestive tract.
  • For nausea:
    Try ginger. Ginger is believed to settle the stomach by suppressing gastric contractions and aiding digestion.
  • For cramps and diarrhea:
    Try peppermint. Peppermint has menthol, which may help control muscle spasms that lead to cramps and the urgent need to go to the bathroom.