Digestive Health Irritable Bowel Syndrome Living With Runners' Colitis and How to Prevent Flare-Ups By Barbara Bolen, PhD Updated on January 03, 2024 Medically reviewed by Aviv Joshua, MS Print Nothing can ruin a good workout like the fear of having a bathroom accident, especially if you've been diagnosed with a condition that makes you prone to such problems, like runners' colitis. While this condition typically affects elite athletes who routinely run long distances, even ordinary folks who run intensely may experience flare-ups. Sam Edwards / Caiaimage / Getty Images Overview Colitis is simply an inflammation of the colon. Runners may experience the condition temporarily due to the intensity of their workouts. Symptoms may last for hours, days, or weeks, and runners are vulnerable because running requires the body to send oxygen-rich blood to the large muscles, a process that reroutes this blood away from other body parts, such as the gastrointestinal tract. The dehydration runners experience and the harsh movement of the body during exercise may also aggravate the GI tract, resulting in colitis. Symptoms of the condition include gurgling, cramping, and loose bowels that can certainly amp up a runner's anxiety. Runners' diarrhea, which has been linked to colitis, is the term for the group of diarrhea-related symptoms brought on by intense or prolonged exercise. In addition to intestinal cramping or loose and frequent stools, this decidedly unpleasant phenomenon may manifest itself through fecal incontinence and (on rare occasions) rectal bleeding. These symptoms may appear during or after exercising and are most common when people engage in long-distance running. Avoid Known Triggers There are several identifiable factors that affect your gut’s motility, thereby increasing the frequency of intestinal contractions and resulting in diarrhea symptoms. Thus, the basic recommendations for reducing the risk of runners' diarrhea have to do with avoiding these factors: Don’t eat two hours before exercise. Avoid caffeine and hot drinks on the day of exercise. Avoid known intestinal triggers and gas-producing foods starting the day before a big event. If you know you are sensitive to foods high in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), as may be seen in people with irritable bowel syndrome, use a low-FODMAP diet before exercise. Avoid Other Contributing Factors Research performed on marathon runners has pinpointed other potential contributing factors for runners' diarrhea. The following appear to result in changes within the gastrointestinal system, changes that increase the risk of diarrhea symptoms: Don't take aspirin or ibuprofen. If possible, avoid these products prior to or during exercise. Stay hydrated. Adequate fluid intake is important for many aspects of health and performance while exercising, including reducing your risk of GI symptoms. Avoid dairy products if you think you may be lactose intolerant. Nervous Diarrhea Nervous diarrhea is the term for diarrhea symptoms that are experienced prior to intense exercise. You may be more at risk for nervous diarrhea if you have irritable bowel syndrome (IBS), are lactose intolerant, or have irregular bowel habits. Here are tips for avoiding stress-related diarrhea: Know your food triggers and look for a diet that reduces them. Learn relaxation exercises to keep your system calm prior to exercising. Schedule your workouts during times when you know that your digestive system is quieter. 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Erdman KA, Jones KW, Madden RF, Gammack N, Parnell JA. Dietary patterns in runners with gastrointestinal disorders. Nutrients. 2021;13(2):448. doi:10.3390/nu13020448 Faress A, Masood S, Mian A. 'Runs' from a run: A case of exercise induced ischemic colitis. World J Emerg Med. 2017;8(4):302-304. doi:10.5847/wjem.j.1920-8642.2017.04.010 Faress A, Masood S, Mian A. Case letter: 'Runs' from a run: A case of exercise induced ischemic colitis. World J Emerg Med. 2017:8(4). doi:10.5847/wjem.j.1920–8642.2017.04.010 McCoy J. 6 foods that can give you runner’s tots—and what to eat instead. Runner's World. Aschwanden C. The pill problem. Runner's World. Cleveland Clinic. Irritable bowel syndrome (IBS): Q & A. Yang J, Fox M, Cong Y, Chu H, Zheng X, Long Y, Fried M, Dai N. Lactose intolerance in irritable bowel syndrome patients with diarrhoea: the roles of anxiety, activation of the innate mucosal immune system and visceral sensitivity. Aliment Pharmacol Ther. 2014;39(3):302-11. doi:10.1111/apt.12582 Cleveland Clinic Health Essentials. Yes, anxiety poops are totally a thing—here's how to find relief. Additional Reading Lambert GP, Boylan M, Laventure JP, Bull A, Lanspa S. Effect of Aspirin and Ibuprofen on GI Permeability During Exercise. Int J Sports Med. 2007;28(9):722-6. doi:10.1055/s-2007-964891 Lambert GP, Lang J, Bull A, et al. Fluid Restriction During Running Increases GI Permeability. Int J Sports Med. 2008;29(3):194-8. doi:10.1055/s-2007-965163 Smetanka RD, Lambert GP, Murray R, Eddy D, Horn M, Gisolfi CV. Intestinal Permeability in Runners in the 1996 Chicago Marathon. Int J Sport Nutr. 1999;9(4):426-33. Sullivan SN, Wong C. Runners’ Diarrhea: Different Patterns and Associated Factors. J Clin Gastroenterol. 1992;14(2):101-4. doi:10.1097/00004836-199203000-00005 By Barbara Bolen, PhD Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit