Does anyone know anything (have any studies been done) about how different anti-diarrheal medications (loperamide and bismuth being the two primary ones I am aware of) effect nutition absorbtion? What about other performance limiting effects?
I used to take an Imodium AD (loperamide) before long climbing days on multi-pitch walls because Number 2 while hanging from a harness on a rock wall is a serious logistical nightmare. If everything was functioning normally at the start, one Imordium just made sure that I made it through that day without having to stop. But, I was not operating at the sustained level of intensity that I am during an IM. I have not typically had GI problems during extended exercise (including IM) but was thinking that it might be a nice insurance policy against unwanted pit stops on race day. However, I certainly do not want to do it if it is going to negatively effecct performance, as that will surely outweight the couple of minutes I might lose to finding a port-o-john.
I use it all the time in races, my anxiety gets the best of me… some people get the luck of peeing when anxious, I get to piss out of my ass. Immodium or generic brand is a staple for me, it has been added to my race day checklist.
You don’t happen to remember where you read that, do you? That would make me feel much more comfortable that I was not somehow shooting myself in the foot.
IMODIUM® products work to provide diarrhea relief by slowing down the motility of the intestinal wall, allowing the body to reabsorb any excess liquid. IMODIUM® effectively reduces stool output and frequency, improves stool consistency and relieves symptoms of abdominal cramping and fecal incontinence.
IMODIUM® Advanced products also relieve abdominal pain, bloating and cramping associated with gas.
Loperamide: Don’t take this if you have any type of colitis. May mask dehydration or electrolyte imbalance.
Bismuth: Large doses increase the risk of hypoglycemia. If you are type I or II this wouldn’t be good race day. And, it throws off a lot of your blood lab values.
Unless someone wants to dig into a PDR, I don’t see a significant alteration in absorption rates if taken as directed.
Interesting. It sounds like that might even help with staying hydrated. I guess I am just worried that somehow that slowing down of the intestinal wall motility might also slow down the ability of the intestinal wall to absorb nutrients. I have no basis for that, it just occured to me as a possibility and I hate unintended consequences.
It is my third line treatment when patients present with “runners trots”
Evacuate before the race. A good strong cup of coffee usually does the job.
Don’t do anything stupid with your diet (includes limiting fiber for 1-4 days before event)
Loperamide
I don’t know if there is any research on this, but it is very commonly done. Theoretic risk of colitis or worsening infectious diarrhea, but I have never heard of it being an actual clinical concern.
I don’t know anything about pepto for runners diarrhea.
There should be no absorption issues with loperamide. There were some old pediatrics ER studies for treating kids with infectious diarrhea with loperamide and a sugar/salt drink. Did well with hydration, but diarrhea lasted longer. I have no idea what the reference is, but I think it is pretty old.