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Gastric distress

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Old 05-21-11, 12:00 PM
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Gastric distress

We see a lot of interest and questions about gear on the LD forum. Bikes, wheels, tires, gears, saddles: all seem to be subjects of great interest among those who are riding or would like to ride long distances. In the first 50 threads up currently, there is one thread with some small concern about nutrition.

Comes now a study of ultramarathon runners by Dr. Martin Hoffman, published in the International Journal of Sports Physiology and Performance. https://ws100.com/research.htm
This study was reviewed by Jason Koop, a CTS coach and ultramarathoner, at https://trainright.com/gut-check-tech...ur-race-early/

From Mr. Koop:
One of the most interesting findings was the havoc nausea and/or vomiting causes for both finishers and non-finishers during the events. When the non-finishers were asked what caused them to withdraw, 23% reported ‘vomiting and/or nausea’ as the culprit, more than any other factor. As a comparison, the total number of people citing injury, blisters, muscle cramps, and exhaustion was only 21.6%. This means that more people dropped out of the two races due to GI distress than injury, blisters, cramps and exhaustion COMBINED!
Also, as to DNFs:
I’ll revert to the research: only 0.7% of non-finishers reported ‘inadequately trained’ as the reason for the dreaded DNF (that’s not a typo: point-seven percent, less than 1 percent). A whopping 23 % cited nausea as the offender, nearly 33 times the amount of ‘inadequately trained’. So if you want to finish, you need to train your stomach as well (if not better) than your lungs and legs. I have my athletes do this by taking in more calories than they usually do in at least one training session per week. If you normally take in 200 calories per hour, try 300. Try to find the limit of what your gut can accommodate and perform well with, and then test those limits.
Mr. Koop goes on to give a few recommendations for what to do if things go wrong.

This has also been my experience as a ride leader and sometime coach. I've had to help more people with gastic distress than any other single thing, including getting lost. So if you're planning on doing longer or harder rides than you're used to, feeding during the ride is the most important thing you can work on. Much more important than what tires you run. Very few people understand this.

The stories I've heard from RAAMers and ultra racers often concern how their fueling plan went totally in the toilet, so to speak, and what they then did to salvage it. If anyone has a story to share, I'd like to hear it.
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Old 05-21-11, 06:40 PM
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Great article. I think it pretty much says some of what I would say works well for myself. Personally, I have started to use "energy drinks" and bars less and less. I still use HEED, but only one scoop in a bottle and alternate that with plain water. Hammer Fizz or Nuun tabs are great. I found out the hard way that Perpetuem may have been good for me on short club rides, but on my first double century it failed horribly. I can't stand the stuff at all anymore. On that ride, I tossed it all out at the second rest stop and munched on pbj's and gels with plain water. I finished with a good time and felt much better than I was earlier that day. As the article says, sometimes you have to ease up a little bit. I'm at the point where I can tell if my stomach is filling up and food is just sitting there, so I go easy for an hour and munch a few Tums, sipping lots of plain water. One thing that helps me is to get some tea. I have an easier time eating if I'm relaxed and focused.
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Old 05-21-11, 06:49 PM
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I get nausea routinely on hard efforts after about 5hrs. It comes on suddenly(usually theres a reasonable hill involved). The good news is I have to back off my pace to make it go away. My legs love it.
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Old 05-21-11, 07:57 PM
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Does anybody has a good way to recover from your stomach throwing a sissy fit?

Yesterday I was around half way down a 95-mile trip, with he first half being mostly uphill. I took a break, ate half a fat PBJ with a red bull and went on my merry way. It was a long gentle downhill and it fell sooooooo good to finally be able to crank away that I overdid it and got rewarded with a sharp knot on my stomach. For a while I thought the PBJ was about to volunteer to come out so I can visually inspect what was wrong with it

Is there a way to soothe a pissed-off stomach?
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Old 05-21-11, 09:04 PM
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For me, three things help:

1) Stop! Nothing fixes my stomach like 10 minutes off the bike--as we all know, the body digests food better when you're not otherwise taxing the system.
2) East more salty foods (Fritos!) and less sugary ones.
3) Drink water. I always make sure I have at least one bottle with nothing but water in it.
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Old 05-21-11, 09:11 PM
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Originally Posted by stlutz
3) Drink water. I always make sure I have at least one bottle with nothing but water in it.
I learned this the hard way.
I was on a hot century one day and had maltodextrin/fructose mix in both bottles.
I got mild nausea and couldn't stand to drink it, but was thirsty as hell.
Unfortunately, places to get water were few and far between, and I got dehydrated before I finally found a place to get water. That last 30 miles were some of the longest miles ever.
Now I always have a rule to have plain water in one bottle.
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Old 05-21-11, 09:40 PM
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Plain water in one bottle. Take 2 Endurolytes at the first sign, then two more after maybe 1/2 hour. Small frequent drinks on some schedule - 3 swallows every 5 minutes maybe max. Don't eat or drink anything with calories until I feel hungry, but continue to push water. Koop recommends ginger. Never tried it.
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Old 05-22-11, 08:48 AM
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Nutrition and food tolerance are obviously very important.

However, I don't think the Leadville run results reflect what happens in ultracycling, or at least doesn't match the Bicycle Quarterly survey results from the 2007 PBP:

https://www.google.com/url?sa=t&sourc...h_ep0Y99TZRvgQ

26% = broom wagon
4% = equipment failure
14% = fatigue
14% = digestion
42% = all other illnesses and injuries

I would assume that it's much more difficult to digest food while running, thus a much bigger problem for ultramarathoners than ultracyclists.
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Old 06-03-11, 08:33 AM
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Originally Posted by abdon
Does anybody has a good way to recover from your stomach throwing a sissy fit?
I struggle with gastric issues on long rides, and when my stomach gets upset, what helps me are things like ...

-- Easing up on the cycling or stoping all together, briefly. If I stop, sometimes walking helps.
-- Deep slow breathing
-- Little sips of plain water
-- Mints ... I use them if my stomach isn't too happy when I'm not on the bicycle too.
-- Zantac. I've tried Tums and Rolaids, and things like that, but Zantac seems to work for me.


But, I've had quite a bit of experience trying to prevent gastric distress, and these are some tips that work for me ...

-- Nibbling my food rather than trying to down a whole sandwich or whole granola bar all at once. To aid in my endeavor to nibble, I use a bento bag and put my food of choice in there. That way I can take a bite, and then put it away for the next 10 or 15 minutes.

-- Choosing foods that I like, and not only that I like in general, but especially things that I like and crave at the moment. I've discovered that if I'm craving it, I'll eat it and it will stay down. But if, for some reason, it is not quite what I want, I struggle to get it down.

-- If I'm on a ride where I'll sleep for an hour or two, I'll eat first and then sleep to give my stomach a chance to digest the food.

-- In general, when I pull out of a control where I might have stopped for a meal, I ride a little bit easier for a little while to give my stomach a chance to digest the food.

-- I take a Zantac before I ride a long distance, and if the ride is quite long, I might take another one or two throughout the ride.

-- One recent discovery is that taking electrolyte pills can help ease the nausea. That has worked for me several times in the last couple years.

-- Liquid nutrition is good. I like Ensure Plus the best of all I've tried. It's harder to get here in Australia, but in Canada I used to carry a couple bottles with me on my randonnees and I would save them for toward the end of the ride when I started struggling with consuming solid food. Gels can also be good to get me through a tough spot.

-- And sort of along the lines of liquid nutrition ... I have found that coke can help settle my stomach a bit and give me some energy, but even better is the sweet bottled iced teas. I've done significant portions of long rides on iced tea. Those iced teas often have potassium which is one of the electrolytes, so maybe that's part of it. Plus tea can be settling anyway.
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Old 06-03-11, 11:02 AM
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Originally Posted by Bacciagalupe
...I would assume that it's much more difficult to digest food while running, thus a much bigger problem for ultramarathoners than ultracyclists.

I think you are kind of on the right track. It's not neccessarily harder for runners to digest than cyclists. It depends on effort. The difference between running and cycling is the constant effort required for running vs. the non-constant effort in cycling. Your digestive track has a very difficult time digesting during hard physical effort because blood flow is diverted from the digestive track to the muscles. When you are running you get no break. Cyclists get breaks every so often. Even long distance racers get a break on descents. If you compare DNF reasons for long distance racers vs. randonneurs you'll see that stomach issues are a much bigger problem for racers. Most randonneurs are not running flat out for the whole distance and they take sleep/rest breaks so there is time to digest properly.

That's why the smart randonneurs eat a really big meal before sleeping on 1200ks.
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Old 06-03-11, 11:33 AM
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I would have a stomach problem usually after big meals. This year I started using Spiz (liquid food) during the rides and limited the size of meals at controls and so far I have not had any gastric distress this year (up to 400k).
Before usually a bottle of Coke and some rest off the bike seemed to help a bit also.
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Old 06-03-11, 11:37 AM
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It seems odd to me, since it's very acidic and causes gastic distress for many, that orange juice seems to be one of my favorite remedies for nausea on long rides. But it works for me, especially on hot rides, maybe it's the potassium.

.
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Old 06-03-11, 11:53 AM
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Originally Posted by Machka
I struggle with gastric issues on long rides, and when my stomach gets upset, what helps me are things like ...

-- Easing up on the cycling or stoping all together, briefly. If I stop, sometimes walking helps.
-- Deep slow breathing
-- Little sips of plain water
-- Mints ... I use them if my stomach isn't too happy when I'm not on the bicycle too.
-- Zantac. I've tried Tums and Rolaids, and things like that, but Zantac seems to work for me.


But, I've had quite a bit of experience trying to prevent gastric distress, and these are some tips that work for me ...

-- Nibbling my food rather than trying to down a whole sandwich or whole granola bar all at once. To aid in my endeavor to nibble, I use a bento bag and put my food of choice in there. That way I can take a bite, and then put it away for the next 10 or 15 minutes.

-- Choosing foods that I like, and not only that I like in general, but especially things that I like and crave at the moment. I've discovered that if I'm craving it, I'll eat it and it will stay down. But if, for some reason, it is not quite what I want, I struggle to get it down.

-- If I'm on a ride where I'll sleep for an hour or two, I'll eat first and then sleep to give my stomach a chance to digest the food.

-- In general, when I pull out of a control where I might have stopped for a meal, I ride a little bit easier for a little while to give my stomach a chance to digest the food.

-- I take a Zantac before I ride a long distance, and if the ride is quite long, I might take another one or two throughout the ride.

-- One recent discovery is that taking electrolyte pills can help ease the nausea. That has worked for me several times in the last couple years.

-- Liquid nutrition is good. I like Ensure Plus the best of all I've tried. It's harder to get here in Australia, but in Canada I used to carry a couple bottles with me on my randonnees and I would save them for toward the end of the ride when I started struggling with consuming solid food. Gels can also be good to get me through a tough spot.

-- And sort of along the lines of liquid nutrition ... I have found that coke can help settle my stomach a bit and give me some energy, but even better is the sweet bottled iced teas. I've done significant portions of long rides on iced tea. Those iced teas often have potassium which is one of the electrolytes, so maybe that's part of it. Plus tea can be settling anyway.
All excellent tips, IME. Stoker and I were on a long, hard tandem ride a few weeks ago. We stopped at a coffee shop, feeling suddenly whupped. We had over-run our nutrition, and worked harder than we could replace calories. I couldn't even get my jaw muscles to chew. We sat and tried to eat and drink for 1/2 hour by the clock, got up and left. We were fine after. Just that 1/2 hr. enabled our systems to catch up. No gastric distress, just overdid it, for us.

Thinking of frequency where I've given aid to another rider, not counting flats, I'm guessing on a ratio of about 3 bonk, 2 gastric, 2 cramps, 1 mechanical. The most frequent mechanical IME has been a broken chain, then a broken spoke, followed by a bike broken in an accident. I've never seen anyone end a ride because of exhaustion, though it probably happens, just not near me.

Oddly enough, no one else seemed to have noticed that Baccia's link doesn't lead to the BQ survey. If anyone is actually interested in reading it, it can be found here:
https://www.bikequarterly.com/BQPBPEquipsurvey.pdf
I found it very interesting, even if I might interpret some of it differently than Jan.
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