Stress and nerves: Do your symptoms get worse when you are nervous or stressed?
- Intensity of running: Are symptoms worse during intense running—e.g. competing and training at or above race pace?
- Are there any underlying gut problems?
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Do you or members of your family have a history of irritable bowel syndrome, coeliac disease/gluten intolerance, Cohn’s disease? - Foods in your everyday diet: Have you identified whether certain foods, or large quantities of these foods, cause gut problems that become worse when you run?
- Examples: too much fibre too much lactose (milk, ice cream and milk-based products) too much fructose that is not accompanied by a good ratio of glucose (dried fruit, fruit juices, certain fruits such as apples, pears, melons and grapes) too much sorbitol (e.g. sugar-free chewing gum) too many stone fruits (plums and apricots, etc.)
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Caffeine as a gastric irritant: How many serves of concentrated caffeine do you have each day, and when are they consumed in relation to training?
- Dehydration: Some studies have shown that dehydration increases the incidence of gastrointestinal complaints. Could this be adding to your problem—especially if you are limiting fluid intake in the belief that it could be the cause of your distress?
- Timing of pre-exercise meal: Have you experimented with changing the time of your last food intake before training or racing?
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- Size of pre-exercise meal: Have you experimented with changing the amount of food eaten in the pre-exercise meal?
- Type of food in pre-exercise meal: Do your pre-workout menus provide significant amounts of protein, fat or fiber? Do they provide lactose or fructose? Have you experimented with changing the foods in these meals?
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Intake during exercise: Do you consume carbohydrate-containing drinks or solid foods during exercise? What are the types and concentrations of carbohydrate in these fuel sources, and have you experimented with changing them? If you are eating solid foods, do they contain significant amounts of fat, protein or fibre?
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