Running with IBS! 🏃‍♀️

[Runningemily]

Hi all- just wondering if there are any other runners out there and If they have any tips for managing IBS during runs?!

I personally really struggle - I find sometimes I can’t run 10 mins without needing to go to the toilet! I do have occasional good runs to however! Just wondering if anyone else suffers and if they have any tips?

So far I’ve tried Imodium, fibre supplements, cutting out certain foods (gluten, dairy, onions/garlic and red meat) , taking Buscopan before a run.

I find Buscopan helps slightly with cramps. I also however am aware that some runs I don’t have any symptoms and don’t want to end up chemically dependant on a pre run Buscopan... (this might be totally unreasonable, advice would be appreciated!)

Thanks in advance - my personal words of wisdom would be take tissues and never run further than a 20min walk/hobble/buttock clenched wobble from a toilet!

[asbayford]

Hey, have you looked into the low fodmap diet? Total game changer

[xjrs]

It might be more of a case of trying to getting the IBS more under control in general rather than focusing on it flaring up on a run. Once it is generally under control you'll probably find it won't trigger whilst running.

Here is some information about IBS that I have shared with others in this group:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/....

This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[IBS-sufferer-123]

Hi Emily - this is a constant challenge of mine, too! I used to get up, down a pint of water, and go straight out for a run without thinking about it, but after a few difficult runs I've found that I need to keep as close as possible to my usual morning routine.

So, for me, that's a coffee, breakfast, go to the toilet, wait an hour, then go. The downside is that it's obviously pretty difficult to go for a long run before work without getting up super-early, so I'm nowhere near as fit as I used to be and tend to stick to 5Ks.

The other thing is exactly what you've mentioned, trying to plan a route which takes you past toilets. I live in a city so on most of my runs I could get to a coffee shop within five minutes! I very rarely need them but I think my issue is psychological as much as it is physical - knowing that there are toilets nearby helps me to relax so I'm not as likely to need them.

Lastly, I think that xjrs 's first point is a good one. I found that my runs got easier when my IBS got a bit easier, and they're worse when my IBS is worse - so, the more you can get your overall IBS situation under control (easier said than done, obviously!), the easier running will be.