I’ve had this problem for years and can’t seem to find a solution, so I’m hoping someone can suggest where I might look for professional guidance. Not sure if it’s a nutritionist, dietician, family doctor, etc, but I’m open to any and all suggestions.
I raced LP last weekend and it was pretty typical of what I’ve been dealing with. This year for the bike I went with UCAN for calories and drank Mortal for electrolytes. I felt pretty good coming out of T2 and started the run with a gel every 3 miles or so and 1-2 cups of Mortal/ice at each aid station. By about 12 miles in I was getting more and more thirsty, but also feeling more and more full/bloated. (which makes me think that dehydration might be part of the problem) I hit the aid station at mile 16 and took in two cups and within minutes my stomach revolted and by mile 17 I couldn’t physically run any more. Just an intense nausea feeling that I tried to get rid of by emptying my stomach, but hardly anything would come up and eventually nothing at all. I even sat down for about 20 minutes at one point because I felt so miserable, but even that didn’t help.
I’m literally at wits end with this. It’s happened for several 70.3s as well, but the full IMs hurt the most. I’ve tried nearly every liquid nutrition out there all with the same end result. (One of the reasons I went with UCAN this year was a theory that perhaps I might be sensitive to malto)
If you can do anything to help an old guy out, I sure would appreciate it. I’m not sure how many more of these I can do and I would like to finish at least one more proud of my result.
Does it happen during training sessions? And if not, the answer to your question is also your answer to why you get sick during races.
It’s likely one of two things. Either your racing harder than you train and your digestive system can’t keep up, or your fueling differently during training than races and your digestive system isn’t trained for what you’re doing during races.
I’m somewhat with you in your experience in the two Ironmans I’ve done. Full on gastroparesis during the marathon and for me it doesn’t go away until I get an IV. Vomiting, bloating, stomach just completely revolts and racing turns into a mental battle to get to the finish line walk/jog unable to take anything in.
My thought is the clue is in the fix… I’m dehydrated in spite of thinking I came off the bike in great shape. If I attempt another Ironman my current coach has said I need to be drinking 2-3x on the bike what I did in my previous attempts.
Otherwise your gel every 3 miles or so and the splash of water through aid stations is what works really well for me on long runs. Again another clue that I’m probably dehydrated off the bike even though I ‘feel’ great initially.
I also duplicated this in training once. Long run day and I hadn’t figured out my run nutrition/hydration and ended up in the ER. Was unable to stop vomiting for an hour or two after my run, unable to keep anything down. My wife/daughter were quite worried and made the call to go to the ER. ER staff finally gave me two bags of fluid (it was almost midnight at this point) and I went home, ate a PBJ and went to sleep. Nothing came from testing, electrolytes checked out but again, two bags of fluid and I was immediately better.
I had a slightly similar experience last July doing full ironman distance event. Thought I had fuelled well on bike and prior to race, both days before and on the morning itself. However, found gels really hard work, despite training with them, and had a very bloated feeling in stomach which i couldn’t shift despite attempting from both ends. Had to walk 2 miles to get myself back in the right mindset and then lost out on an age group podium place by less than 2 minutes, which made me feel even more sorry for myself.
I spoke to a semi pro/top AGer/coach afterwards and they recommended I listen to a recent podcast episode of pro tri news, where Mark Matthews spoke with the nutritionist from the Bohe-Hansgrohe Tour de France team, a Slovakian called Tim Pogladar. Episode came out in spring 2023.
The episode covered lots but key things I learnt and have since used successfully are:
fuel basic in 72 hours before race and remove vegetables from diet. Also remove lactose/dairy as much as possible in final 24 hours. prioritise glycogen from carbs - pasta, rice, gummy bears. (I’ve since noticed lot of pros and AGers just eat plain rice day before for all 3 meals, but I’m more a pizza person)don’t use porridge/oats on day of race. Slow release not helpful if you are doing a long endurance event as you need to start topping up/replacing glycogen levels as much and as soon as possible, plus it can sit in your stomach. Use toast/bagels and jam for breakfast - more sugar the better.Get carbs in from drink/chews/gels on bike but in last 30 mins, use drink just for electrolytes onlyGo for 100+g carbs per hr first 75% of bike then lower to 60g as you get body ready for run and then on run. Chug another gel in t2/end of bikeFor run, I take own flask (x2) of 500ml water plus electrolyte tab to drink regularly, and put 4 sis beta gels in a smaller handheld flask and take a few sips every mile from mile 5. You then don’t need to stop at aid stations and removes excuse to walk/keeps legs spinning over. Don’t drink carbs as by the time of the run, you need liquids purely for hydration. Adding carbs to that side of the equation complicates things for your stomach which will be getting a lot less blood than usual.Treat myself to a coke at last aid station for final sugar hit and only 1-2 miles left to go.
Obviously need to practice this and different things work for different people but I listened to the podcast about three times and made detailed notes, as he sets out a fuelling strategy from 72hrs pre race to end of marathon. Followed these steps for Ironman Portugal in October 2023 and had my best run to date, certainly in terms of how I felt doing it.
Good luck and hope you find something that works for you.
I’d wager you’re racing harder than your training and capabilities. People don’t want to hear that but it’s often the truth they need to hear. People will fight that saying “I trained like this, blah, blah, blah, and it worked in training, blah, blah, blah.†Race day is very much a different beast. You cannot replicate race day in training. Folks don’t do a 2.4/112/26.2 or 1.2/56/13.1 training day.
Go slower.
By your own admission you’ve tried all kinds of different nutritional and hydration strategies. Try slowing down. Slowing down is often the magic elixir.
I’d wager you’re racing harder than your training and capabilities. People don’t want to hear that but it’s often the truth they need to hear. People will fight that saying “I trained like this, blah, blah, blah, and it worked in training, blah, blah, blah.†Race day is very much a different beast. You cannot replicate race day in training. Folks don’t do a 2.4/112/26.2 or 1.2/56/13.1 training day.
Go slower.
By your own admission you’ve tried all kinds of different nutritional and hydration strategies. Try slowing down. Slowing down is often the magic elixir.
I agree with GMAN with a slight caveat. 95% of the time it’s that you raced harder than your capabilities, and more specifically, raced harder, faster and longer than your Nutrition would allow. I’m surprised that Dr. Alex Harrison hasn’t chimed in, but I’m sure he can give you all kinds of insight into how to improve that. As people become more dehydrated, their sympathetic drive fires up, the splanchnic blood flow reduces (flow to the gut), and their GI motility shuts down, leading to the bloating and nausea that you feel. Add the possibility of heat exhaustion and increased insensible fluid and salt loss through sweating, and it’s a recipe for a very bad day.
Big takeaway, find a better nutrition plan. I personally love the Saturday app, which makes it super-simple and as cheap as you want it to be.
I appreciate everyone’s feedback. I’m generally very careful in what I eat going into races and I’ve thought about the ‘racing too hard’ theory before. My bike average was 137W on an FTP of about 220W and I was shuffling along around an 11:10/mile pace before it went really south, so I don’t think I’m pushing myself too hard. My PR time is 12:00 at IMFL and I was on track to be close to 13:00 at a very tough LP.
I’ve always associated the bloating with a “full” stomach, but I wasn’t able to get hardly more than a few ounces to come back up. So, I’m wondering if I’m just not taking enough liquid in over the bike? Visually, at least, I’m not a heavy or salty sweater, but I’m thinking of adding in electrolyte tablets as I find the extra salty drinks hard to get down. Is there such a thing as too much salt during a race?
FWIW, it sounds Lionel also had stomach issues … not that I’m comparing myself to him.
I have had the same issues off the bike in IM races. I have raced IM since I was 23 and at 58 started having big problems. In a couple of my IM’s I would come off the bike feeling ok with sometimes a 40-60 minute lead then by mile 13 in the run be reduced to vomit/jog/walk/repeat. Last year I hired a coach and started using the Saturday App. My next Ironman is Maryland in September so the results of my efforts remain to be seen. I also took 18 months off from any full IM races to try and sort this out. Although I thought my training would have indicated that my times were ok for the IM distance my method of training was off. I was not practicing nutrition as diligently on the bike and run as I should have been. I had always gotten away with “winging itâ€. Then I got older and now It is way different. I hypothesized as you age your body becomes less efficient at digestion just as it does in your swim, bike, run. My new program is much more methodical and focused on durability. I will also add that the Saturday App has made me realize how much more nutrition I needed. I will drink 100 ounces on a 3 hour training ride now vs. 70 oz a year ago. Granted it is very hot where I live but I never would have thought I needed that much nutrition. Don’t give up, I would find a good coach that can point you in the right direction. It isn’t as simple as switching products but blending all the different components together. My 70.3’s have gone great this year so I am hoping I can pace myself and put all my hard work to the test and have a better outcome in September. Good luck!
I would second the sweat testing. I did the Precision Hydration one too.
I’ve been repeatedly frustrated by gastro issues on races over ~4 hours. Discovered through testing that I had more than double the sodium concentration in my sweat than average, on top of a sweat rate about double the average too.
So basically require 4x the sodium and lots more liquid in order to have a stomach willing to go along with processing the carbs I need. It’s made a big difference.