935. 20 tips on what to do if you have stomach issues during an ultramarathon

Your running, pushing your body to its limits 

Maybe a little dehydrated

Stomach issues are slowing you down 

But you keep moving, step after step 

we get to a nice uphill section of the course…

It’s too much. 

We start throwing up all crazy 

I’ve heard crazy stories of people violently vomiting. 

Did you ever have stomach problems during an ultra-marathon?

To me, throwing up during an ultramarathon is because we did something wrong. We didn’t put something in us that we should have (or maybe we did put something in us that we shouldn’t have), or a sign that you have screwed up somewhere in your strategy (energy, fluids, electrolyte, pacing), either way – our body let us know, which is amazing, but not in this case, lol

We’re going to cover:

• The common cause of stomach issues during an ultra
• 20 tips on what to do if you have stomach issues 
• 2 questions to ask ourselves 
• And if all else fails and we gotta puke… 

The common cause of stomach issues during an ultra

Is there a common cause? 

It’s hard to say something specific – there’s variables. 

What did you take before the run? The days leading up to the run? Sleep quality? Nerves? Stress? Training? And so many others. 

But I highly probable answer? I think it’s because there’s not enough sodium. 

Sodium is important because it helps our bodies absorb the nutrients that we just put inside us via food and liquid so they don’t just sit in our stomach. 

But if we’re low on sodium? 

Our bodies don’t absorb any of the stuff we’re taking in. That makes it sit in our stomach longer…

ie the more of a chance that we get that nausea feelings and/or throw up incidents. 

Common ultra food consists of potato chips, pretzels, candies – some of them seem salty but they have nowhere near enough sodium to be effective. 

A pretzel with 30 mg’s of sodium isn’t going to cut it when we need to get 800 mg’s per hour. 

Even 200 mg salt tabs aren’t cutting it, they help but we need more than that. 

Have a salty dinner the night before the run and have something salty for breakfast. 

For a salty breakfast I like to have a fruit smoothie with a packet of LMNT mixed in there. (1,000 mg of sodium) 

Stay on top of your salts during your run and make sure to get salts after too. Salt salt salt. 

You may find your digestion much happier in the long run. 

20 tips on what to do if you have stomach issues 

Let’s be real, throwing up costs the body a lot of necessary electrolytes and fluid. Here are 20 tips so that you can keep your gains, see what works for you: 

1. Train smart – more than just banging miles – take care of our bodies, how and when we eat, recovery. 
2. Manage your diet, fluids, and electrolytes
3. Eat solid foods as long as you can. Something resembling your normal diet, i.e., some carbs, some protein, some fats. Peanut Butter sandwiches, avocado wraps, something with a little bit of beans or tempeh works well for me. I do liquid calories in the morning via tailwind and tailwind rebuild later on too. 
4. Don’t eat solid food at all – this contradicts the last point, and that’s the point – find what works for you. 
5. Take salt – the cooler it is the less we need. It’s kind of hard to over do it on the salt so I err on the side of too much vs too little.  
6. Really really work on hydration early in the race. Dehydration is common in ultras, and that can lead to nausea. If your pee is not on the clear side and you’re not peeing every 2 hrs or so, you’re probably not drinking enough.
7. Always have a plan – something is better than nothing. Try this or that. Think on your feet. If all else fails, slow down when you start to feel that sloshy nausea. Annoying, yes, but a slow finish is better than a dnf – amiright? 
8. Only eating carbs messes us up after a while – maybe 6 or 7 hours? After that time, ingesting some fat and protein during the run will keep things going.
9. Walk for 5-10 minutes after you eat, especially later in the race. 
10. If you do throw up, be sure to get some water and electrolytes in as soon as you can stomach them.
11. Meditation can help calm the mind, some people let the jitters/ anxiety/ excitement get to them. 
12. Take about 750 mg of sodium/hour, more for hot weather, less for cool weather
13. Do not drink anything made with fructose or very acidic drinks like soda. 
14. Take in about 200 cal/hour more if you’re heavier, less if you’re lighter. 
15. When it’s HOT, try to keep your body temperature down. Ice on neck, wrist, etc. and slow down in the heat of the day.
16. Try anything with ginger. The more natural the better. 
17. When all else fails take a nap. 
18. Keep moving, it may get better!
19. NOTHING NEW AT RACE DAY – why risk how the RD is going to provide electrolyte drink mix at races? Maybe it’s too strong or not enough… 
20. Sometimes throwing up is the thing to do! Just know you’ll need to really get back some fluids.
21. Keep it simple – don’t eat things you wouldn’t normally eat 

2 questions to ask ourselves 

Here are 2 questions to ask yourself. They may help you find the cause of these stomach issues.

1. Do you experience nausea when you are not running? If you do, it makes sense that it’s happening during the run. If not, it’s something that’s going on just before, during, or after the run. (remember salt) 
2. What about the drink/sources you use while running. Do they contain fructose? Sugar? Glucose? – simple sugars? Any soda or fruit juice? These drinks are acidic and during ultra’a our body’s ability to compensate for increased acid intake is affected.

And if all else fails and we gotta puke… 

And of course, if all else fails and we need to puke…

Remember that it happens, 

And don’t puke on your pacer, at an aid station, or on yourself!

I appreciate your attention! 

KEEP ON STEPPIN!!