So , I have goggled all sorts of advice on how to prevent those oh sh*t moments during races or long training days. Practicing in GI medicine it is amusing to me in what the theories are in trying to help athletes.
Here is the best advice as I can give, and it sort of goes along with how we safely purge the bowels prior to a colonoscopy for any of you whom have had the pleasure.
Firstly , My theory is simple. Your diet needs to be easily digested foods for the three days prior that can easily be purged by your overactive nerves on race day morning.
It starts with an elemental diet. Not the exact prescription we would prescribe to a patient in order to medically bypass the bowel or rest the bowels but something very similar. When in medicine you must rest the bowels , you place a patient on a liquid diet which is high nitrogen ( amino acid) , is high also in glucose , is low in fat, and has vitamins and minerals. It is the simplest form of nutrition and guts don't have to do any work to digest it. There is a website for the public in which you can purchase elemental nutrition, and Vivonex 10 is a good brand but this is probably not totally necessary.
I recommend a soft , bland diet of easily digested proteins. For me what works best is tuna, peanut butter, eggs, and protein drinks without milk.
Three days before the event start avoiding fiber. Yes avoid fiber , for fiber is a bulk forming laxative. It does the opposite of what everyone thinks in the gut. It pulls everything together to bulk the stool and fiber is not easily digested. To purge the bowels for surgery or colonoscopy we have patients avoid high fiber for three days.
Also for the three days prior to the event.......
Avoid milk.For most , it causes gas, bloating, diarrhea or constipation. As most of the worlds population is lactose intolerant after the age of 3 at some degree, as we are inefficient at breaking down lactaid. I do however love milk as a post event drink.
Avoid caffeine, as it acts as a gastric irritant, which can increase gastric motility. Besides that caffeine is a weak diuretic and the three days prior to endurance events hydration is super important, so the caffeine is counterintuitive to that.
Avoid red meats and high fats as they take longer to digest.
When I follow these steps , I typically have great results and no , "oh Sh****T! moments.
I have heard people suggest just simply using Imodium, before and during long races. That is crazy to me. Imodium basically just stops peristalsis and prolongs transit time. So eventually the "sh****t , if it is in there has to go somewhere! And the fact that you are exercising and dehydrating you are just setting yourself up to have a "moment " eventually right? If you are doing a 12 hour race , I don't think that is a good game plan.
I have heard other advice as , being take probiotics during race events.
Ok, I love probiotics , but they are not a quick fix. They do help with regularity but should be taken on the long term. They help with gas, bloating , constipation and diarrhea as they are a good bacteria necessary in the guts to help with regularity.
I have also heard the advice of pancreatic enzymes. Again. not sound advice. People with pancreatic insufficiency have a true medical disorder that requires PRESCRIPTION pancreatic enzymes that cost 1000 dollars a month to be on. People with pancreatic insufficiency have diarrhea due to the inability to properly digest fats/lipids . The theory , or why I am hearing that athletes are taking these is because they are trying to digest high fats during race day , to restore , nutritional balance. I say look at the nutrition your trying to use, and it needs to be a better mix of glucose , protein and fats.
I hope all this information helps someone out there.
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