Runner Trots

Ahh, that dreaded runner’s diarrhea or runner’s trots. You finish your run just in time to make it to the closest bathroom. You are stuck in the port a potty thinking about how you will be spending the rest of your post run day in and out of the bathroom feeling like you have food poisoning. However, it isn’t food poisoning, it is runner’s diarrhea. Sometimes you are not so lucky and it hits in the middle of your long run or worse your race. Some of you may have not had first hand experience but have heard stories from your running friends and are paranoid for when it may happen to you.

What is runner’s diarrhea? There can be multiple factors, but the exact cause is not clear. It is thought running cause the nervous system activity to decrease the motility in colon that then shifts after you stop or if you increase intensity. There are thoughts that it could also be related to the shift of fluids in your body affecting your intestinal secretions during movement of your intestines while running resulting in diarrhea.

One thing that we do know is that often it is related to hydration or more importantly being dehydrated. As your body tries to balance out your electrolytes in your body, it will adjust the fluid balance throughout your body including your stools. It seems counterintuitive that if you are dehydrated, your body will produce diarrhea. Just trust me, it is more balancing out the electrolytes in your system.

Ok, that was a lot about why you may have diarrhea with running. More importantly, how can you prevent it. Again, we don’t know all the whys but here are some good places to start.

1. Hydration: it is important to make sure that you are going into a training run or race already hydrated. This can help decrease risk of runner’s trots. It can also help you avoid dehydration if you don’t avoid the mid or post run bathroom stop. Just as important, you need to stay hydrated throughout your run.

2. Diet: avoid high-caloric, fatty or high glycemic meals withing 3 hours of exercising. These foods are more stimulating on your GI track and will just increase the likelihood you will need to make a pit stop.

3. Decrease your pace- intensity does worsen your symptoms. If you decrease your pace, you may be able to avoid a bathroom stop.

4. Antidiarrheal medication: proceed with caution. This obviously can help prevent diarrhea. It is not a good solution for everyone. You want to consult your doctor to make sure this is a safe medication for you. If it is, it can be helpful to decrease the likelihood of diarrhea during your run or race. I usually recommend not taking it if you have a fever or any recent illness in the last 24 hours. This is because your diarrhea may be due to an infection. I also recommend taking half the dose recommended on the package. This help decrease your risk of diarrhea without constipating you by accident. It is good to try this on a long run before race day to see how your body reacts.

Dr. Jennell Kopp
– Medical Director of Athletics and Head Team Physician, University of Denver
– Sports Medicine Physician at Common Spirit
– Colfax Marathon Medical Director