GI Help

Triathlon Forum
1

So 4 years of tri and I can’t quite get it right. Legs are strong, but the stomach has been failing me consistently since my first triathlong (Olympic distance).

I recently did a half iron distance and ended up with the same problems that I always have on the run - stomach cramp. I finished dinner 12 hours before the race start. I probably packed in all that I could over the day before without being bloated.

Breakfast was a coffee, two snack pitas with peanut butter (500 cal approx), lots of water, one banana (100 cal), cal-mag-vit D supp. That means 600 calories. I drove 1.5 hours to the race site so I probably used up a little of that energy, but should have started with a lot of spare fuel in the body. The day turned out to be hot and humid (did not feel like it at the time, does that mean I was not connected to the weather or that the dousing with water at every aid station worked?) and I received a second degree burn on my neck.

Swim went well, but I swallowed a bit more water than I usually do. (36 minutes)

On the bike, I was planning to take 2-3 gels (100 cal each) and 1-2 bottles of sports drink (150 cal each, large water bottles so not too strong). No fluid passed on the bike. (2:46 duration)

The first km of the run went by, and then my stomach acted up. It is a pain on the right side (below heart) of my body that builds until I can’t run. As soon as I slow down the feeling starts to go away. I urinated once about 2 km later and then spent the next 11 km doing a walk run. The pain also hampers my ability to put anything else in my body, but I have learned to still put something in (gatorade, pepsi) so that I do not run out of energy. I probably took in another 200 calories on the run. (2:02 - booo!!!)

Does anyone have any ideas? This does not seem to be related to an overly acidic environment in my stomach (I am vegan), seems to be related to gas (if I burp the pain goes away) and is holding me back from performing as well as I would like. My stand-alone best 1/2 marathon is 1:40 (2 years ago and I am in better shape now) so I should be going a little closer to that.

I have the grand columbian coming up in 2 months and want to try out some solutions in the next month to hammer down my nutrition plan.

Oh yeah, the only things that were different at the race from training were drinking pepsi on the run (did not exacerbate things) and all of my drinks were slightly warm to air temperature on the race. I did get one cup of very cold water and it was amazing! Does that indicate something?

Profile: Front of the MOP, 5 Oly, 3 1/2, 4 marathons, 3 half marathons.

Thanks

2

It is a pain on the right side (below heart)
Your right or my right?

3

The right that is below my heart.

4

So my right if I’m facing you, but my left if I’m either by your side or behind you, facing the same way as you, which would mean it would be you left too.

5

Your anatomy is spot-on, mate! Has someone been playing doctor with you?

:wink:

Jodi

6

I have a couple of ideas (but your post is interesting and I want to see what other say because my wife had the same problem as you yesterday in a race that she was fit for, and we can’t figure out what happened).

  1. What kind of sportsdrink were you using and did it have enough salt in it? I use Infinit with a ton of salt.
  2. Do you think you may have been dehydrated? 2 bottles of fluid in 3-hours of racing on a hot and humid day is not much and you may have been dehydrated by the time you started the run (and then its too late to do much about it);
  3. Did you race harder than you thought you were on the swim or during the bike or beginning of the run and did that lead to stomach shutdown?
  4. what kind of gel were you using and did you have it with plenty of water? I’m a salty sweater, so I have powergels with 4times the sodium or e-gels which also have a lot of salt.
  5. was it a fitness issue and not a nutritional issue? Did you have the endurance to race for 5-hours plus or did you have the endurance to run a 1/2 marathon, bike 56-miles, and swim a mile as seperate events? If you don’t have the endurance to race for 5-plus hours, I would try to get in a bunch of overdistance rides with short transition runs between now and your next half.
    Good luck.
7

I have had similar problems in the past, getting away from Hammer products helped me a lot…

A HIM a few weeks ago gave me a PR with a protocol of starting the bike at a lower HR and then building, less calories than usual on the bike, easy off bike and then building after the first two miles of the run.

Drinking lake water can really mess things up in your system as well, swim with your mouth closed!

8

I had a run in with GI problems for about two years until finally figured out what it was. As far as where the pain is being felt, there could be plenty of explanations. First thing to ask is does it only happen when you run? You drink a lot of caffine and this can cause the LES to relax, allowing acid to reflux. I would also look outside the box, such as vascular or even Pancreatic, given the location of the pain. Also I had a “dead” gallbladder that presented pain in the middle of my chest, not to the right like most MD’s would think. As far as your diet, you are less likely to develop reflux but not immune. In my experience the GI system is like the far corners of space, there is a lot of it out there they just can’t really see, although I did have the pill endoscopy, but you have to hit the spot dead on to take the pic of the “problem” area. I would start with a check up at a university where they are more inclined to investigate and go from there. I had to wear a device they put on the inside of my esophogus and it measured the acid levels before, during, and after I exercised and when I felt pain I pushed the button. So hopefully you can go somewhere they can really work with you to solve this, good luck

9

Your race and issues are almost identical to mine. I had about the exact same times as you and the same problem on the run in my HIM! It’s been happening in all my triathlons and I dont know whats going on!

10

Pain on the right side right where the rib cage ends? If you eat any spicy foods do you get the pain in the same spot? Is it a very sharp pain?

11

I think we have yet to establish whether this pain is on his right, or on his left. That is, unless he has a crazy deformity that put his heart on the right.

So what is it- is the pain on the left, below your heart, or on the right?

Jodi

12

A few things:

Which ‘right’? 99.999% of people have their heart on the LEFT.

Coffee makes my tummy sour if I have it before exercising. You might have a similar problem.
(I use caffeine pills instead)

Eating too close to race start could also be part of the problem. 3hrs minimum is recommended.

“Lots of water” - could be another part of the problem. Define lots? Could be too much.
Might be better off with less fluids in general, and perhaps try watered down sports drink (aka Gatorade) instead, so you are getting some electroyltes and very slight calories instead of just water.
Worth a shot.

If your HR is elevated more than normal on the bike, you might be digesting more slowly, so therefore whatever cals you took in at the end might’ve still been in yer gut for the run start.
(this is exactly what happened to me my last HIM, I had an almost identical problem, sharp pain on my actual RIGHT side, aka - opposite side as my heart)

The good news is, you have several things you can try out to attempt to remedy that.

13

Eload is the sports drink and hammer was the gel.

I figure I wasn’t dehydrated due to the water I drank before the race, the water I drank during the swim, and the 2 bottles on the ride. If anything, the water that I swallowed during the swim may have put me over.

Race pace was spot on, although the swim was very hectic.

I have the endurance, just not the stomach to run immediately after the bike. This issue happens at every race and the pain does not last as long on the shorter ones (olympic is the shortest I go). I drink 3/4 to 1 bottle on an oly in the summer. And if I belch, the pain generally goes away.

14

Place your hand on your heart. Move down to the last ribs. The pain is there and sharp enough to make me stop running.

15

I eat spicey foods all the time. I get no pain in my stomach, but I eat too much habanero I sing that Johnny Cash song.

The next day if I did a little jog across the street, the pain came back. 2 days after it was gone. The river that I swam in is pretty dirty, is there a chance that I had some mild eColi poisoning?

16

is there a chance that I had some mild eColi poisoning?

Not saying you couldn’t have some sort of bug, but it’s unlikely to be E.coli if it was a stomach problem (that would be more likely a lower GI problem). The kind of pain you describe sounds more viral. Or much more likely, due to nerves. When I get nervous my stomach hurts a lot. Crampy, sharp, horrible stomach pain. Dealt with it for 9 hours of my ironman. Tums made it totally disappear. But I’ve also had a GI bleed caused by an ulcer. It was brought on by NSAID use while exercising. You’re not taking Aleve or Ibuprofin before you race, are you?

Jodi

17

No NSAIDs at all.

No nerves either. The legs were good, I just came off a nice ride and a 21km run does not bother me anymore.

I think my next test are TUMS at the end of the bike. And probably less to drink on the ride to reduce sloshing. I am just concerned about my iron race in September and I know that fuelling on the bike is key to staying alive on the run. This will be my first iron distance race.

18

Well, you might not think you’re nervous, but you probably are. I felt totally calm and collected at CdA, but my body tells me otherwise. I only get that horrible pain when I’m in a situation where I should be nervous.

You could try dosing with prilosec for a week prior to the race. I haven’t tried that, but I’m supposed to be taking it daily. I took it for a month after my GI bleed and it helped a ton. But then when I healed up I stopped taking it.

Jodi

19

This possible solution came up on the TriRudy.com mailing today:

SIDE STITCHES

Side stitches can be a major pain – especially when they pop up during a hard workout or race. Here’s how to deal

Definition:

A sharp pain usually felt just below the rib cage (though sometimes farther up the torso), caused by a cramp in the diaphragm, gas in the intestines or food in the stomach. Stitches normally come on during hard workouts or races.

Remedies:

If you get a stitch on your right side (which is more common),
slow down for 30 seconds or so and exhale forcefully each time your left foot hits the ground. If the stitch is on the left, exhale hard when your right foot lands. Continue until pain recedes. If this doesn’t help, try slow, deep “belly breathing” (your abdomen should go in and out with each breath). Or run with your hands on top of your head and your elbows back while you breathe deeply from your belly.

Another remedy is to take your fist and dig it under your ribcage, push the fist in with your other arm and bend your torso over almost to 90 degrees. Run like this for 10 steps. This stretches the diaphragm, and most stitches are caused by a spasm of the diaphragm. If none of these techniques work, stop and walk until the pain subsides.

20

Get rid of the caffeine - always makes my stomach week,

Day before don’t eat a ton, no dairy, read the amount of fiber you are taking in and don’t eat alot of fruit the day before. Seems like a big breakfast to me. I have always had a week stomach find what foods work and only eat those the day, morning before.

Good luck.