I have some stomach problems

It’s going to be tough for me to describe all of this succinctly, but I’ll give it a shot. I’ve never been able to get any decent answers/advice about this, but I figure this forum is a pretty good place to try again.

I have done a bunch of ultra distance stuff. 18 ironmans and one long distance MTB race (11+ hours). In each, some variation of the same thing has happened to me: Relatively early on the bike my stomach ‘shuts down’, for lack of a better phrase. Food tastes bad, water tastes bad, and I have trouble taking anything in. This is occasionally, but not always, accompanied by needing to pee (a lot) over and over again (I once stopped five times in three hours during an ironman bike leg while barely drinking anything, peeing like a race horse each time).

Once onto the run, I ‘run’ for a while before finally succumbing and throwing up the contents of my stomach. I then continue to ‘run’ to the finish, possibly throwing up a few more times. In the majority of my IM marathons I have taken in very little in the way of water/calories. When I lose it, it’s just vast, vast amounts of liquid coming up.

I have always figured that I just keep ‘getting my nutrition wrong’. Except this last time I got an extra bit of data. I happened to be running with a nurse when I stopped to throw up. He said ‘There is no way it should have been possible for you to have that much liquid in your stomach’. That makes me think that there is possibly more going on here than just a few mg of sodium here and there. My thinking is that my stomach is ceasing to process water/calories relatively early in the bike, and then just filling up until it finally gets so full I have to throw up. I have in the past felt a bloated stomach (mainly characterized by my knees hitting it while in the aero position), but not every time.

I have tried pretty much every nutritional variation out there. High/low calorie, high/low sodium, all liquid calories, mostly solid calories, etc, etc. And yet the same thing always happens. Sometime I feel good to mile 80 on the bike, sometimes is starts at mile 40. Sometime I make it to mile 20 before puking, sometimes not nearly that far. Like I said, all these races have been variations on a theme. I think I am a moderate sweater and it is very rare for me to see salt stains on my kit after long rides.

As you can guess, this is all very vexing. However, I think the most annoying thing is that I can NEVER replicate this in training. My training is always awesome. Really. 4-5 hour ride followed by a 5-10 mile run? No sweat, feel great, stomach behaves like a champ. I follow my nutrition plan exactly in training and feel great, then race day comes and I feel like I’m out of it right away. At IM Texas last April I was feeling off by mile 40, needing to force myself to eat and drink.

This is one of those things that is so annoying that I keep trying to give up long distance stuff and just focus on events of 1-3 hours in length, where I don’t have to worry so much about nutrition. But I keep feeling the pull back to the longer stuff (much to my wife’s chagrin :slight_smile: ).

I am a strong swimmer, a fairly strong cyclist, and a poor runner. Actually, I’m a pretty decent runner in training, but when I get to the run in an IM, I’m always so far off the cliff that I can’t actually run.

If anyone has help/advice/comments/questions, I would love to hear them. The only thing that I have thought of is the fact that I don’t do a lot of swim-bike bricks. But I do swim quite a bit, so I don’t know that I really believe swim-bike bricks are the answer to my problems.

Thanks

No help, but a couple of additional questions:

Do you take on a lot of water during the swim? (Wouldn’t expect that of a strong swimmer)

What happened in the mtb race?

Do you have issues not being able to eat when you’re nervous in other parts of your life (like important work meetings)?

Do you train in your TT position?

Have you had similar issues in half IMs (or shorter races)?

Have you considered prebiotics and probiotics? Might be worth exploring the whole gut health side of things…

You said that it only happens in races and not training. Obvious question: Do you think there might be a psychological element i.e. too tense/anxious? I have had many friends loose their breakfasts before competitions… not usually during them though.

Thanks for the replies, all good questions.

No, I don’t believe so.

High Cascades 100 was about the same. I was feeling great until about half way through, then the usual: wanted to stop eating/drinking, nothing tasted good, etc. I was a wreck afterwards, but managed to not throw up.

No, never.

Yes, basically exclusively before a big race. That was the main reason I first bought my Kickr.

In halves sometimes I feel great and sometimes I feel the stomach issues, but I finish before things get ‘full on’.

Certainly an interesting idea, I will look into it.

Yes, absolutely I thought this might be the case. In my ‘early career’ I did put a lot of pressure on myself. I wanted to be fast fast fast. I trained hard and I wanted to race well. That never worked. I did 16 IMs from 2005 to 2011. But then I stopped and started racing cross. I did the MTB race in 2016, no goals, no expectations, same outcome. And I did IM TX last April because I got bitten by the IM bug again. No goals, no expectations, same outcome.

If you had he same issue in the mtb race I guess that sort of rules out the swim and run as the core issues, and TT position.

Maybe you’re simply drinking too much?

Yeah, and I’ve definitely tried drinking less, but to no avail. I drink the same thing/amount in training as in racing.

Worth talking to a sports psyche if you have eliminated physical issues. How’s the blood pressure?

Not the worst idea. Blood pressure is good.

I suppose I should mention sleep. I’m generally a sleeper on the best of days, but the night before a long course race I’m absolutely rubbish. I generally get ~2 hours of actual sleep before an Ironman (with the exception of this last one, when I got ~7). I know the old adage of ‘it’s the night before the night before’, but an ironman on 45 minutes of sleep still can’t be optimal.

Needless to say that I try not to replicate that in training…

I can understand being frustrated by this! Do you take anything over the counter on race days?

Do you have any digestive discomfort or troubles aside from racing? What exactly are you drinking?

Doesn’t this imply that nerves is at least part of the issue?

I’m a fairly heavy caffeine taker.
I know occasionally the diuretic effect can make piss very frequently. Depending on what foods I have had with it.

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I know that song. I am long in the tooth now and I was never a competitive rider. I scratched that itch with other sports, not endurance, mainly skills and tactics based. Sure as day followed night I would sacrifice the sleep before a competition for endless visualizations and decision tree rehearsals. Then be too shattered the next day to execute anywhere near my level until the whole thing was lost anyway. I would have walked hot coals for a good sports psychologist back then. There just weren’t any.

Anyway there may be a thread for you to pull on there. What is your in race fueling strategy? Technical or real food? The reason I ask this is that insulin spikes play a role in sleep disorders. It would not be a stretch to presume the reverse is a factor. Also the insulin system, from what I read, rings like a bell: peaks following troughs through the day (and night). So maybe low GI fueling strategy would help by flattening the spikes and subsequent gastro distress. Have a Google on sleep and insulin to see.