Warning: This article contains information of a delicate nature and may not be suitable for everyone. It discusses, in some detail, a specific condition which happens to some runners while using a high-fiber, high-carbohydrate diet. "Runners Trots" include, among other things, abdominal cramping and a very sudden, very urgent and torturous need to empty one's bowels.

I won the title of "Best Dressed" in high school. As you can imagine, someone who earns that title from her peers has a high level of interest in looking good! And as I've become more and more passionate about running through the decades since, I find myself matching my sports bras to my running shorts and tennis shoes. I know it isn't very logical, but I find beauty and a deep level of satisfaction in balance and color. It's just my nature.

In addition, I have a passion for fitness and nutrition. I'm one of those people who plans her diet to the "nth" degree each day and journals her actuals meticulously. I plan and track my exercise as well -- strength training and outdoor running while the weather is nice (here in the southern USA it's nice most months!) and track how I feel with different levels of activities and meals so that I can maximize my performance (more miles, faster times, heavier weights, etc) while maximizing my energy and recover well from each workout.

This summer has been fabulous. I created a meal plan based on more complex and simple carbohydrates because I became interested in running more -- longer runs on a daily basis with some speed work, which along with my strength training required more fast- and slow-burning fuel and higher-glycemic carbohydrates post-workout to replenish the blood sugar which had been used up in my muscle. And....the results have been fabulous. I've been running over 30 miles a week and have had full energy all day and through most days of the week, even after days of two or three runs (some with clients).

But as luck would have it in the midst of many of my recent runs--in fact as often as daily and in some cases twice-daily, I found myself literally stopped cold with fear from the too-sudden need to find a bathroom. Let me explain further.

I remember a long walk long ago, in grade school I think, when a certain member of my family had an accident on our way home. This same member of my family would experience a sudden need to empty her bowels it seemed, every time we entered a large department store. In addition to that, another member of my family very frequently would need to find a plunger after visiting the bathroom. So, after finding that I needed to use the bathroom just after my much-less-frequent runs in my 30's (which is when I began light running), I figured it was just my genetics and wasn't too concerned about it. At the time I would run 2 miles once or twice a week and didn't have much trouble otherwise.

Later in my 30's when I began running longer distances, I discovered that I very frequently needed to find a bathroom DURING the run. Usually during the 2nd mile my body would tell me to find cover -- and fast, and during those runs I would be in the vicinity of a facility so there were never any major embarrassments.

However, as my interest and mileage began to increase further, I found that I had to map my routes through areas that had public rest rooms. The need to go became so regular that I wouldn't run with clients. I tried at one point (sorry, Beth), but ended up embarrassing both of us in subsequent runs and had to discontinue the sessions.

So as my running career became solo, I came all the way to this point, the last week in July of 2005, finding myself absolutely tortured with as many as 3 urgent and fear-filled sprints to get to a facility on any given long-run day. In fact, during this week in particular, every single run was plaqued with at least one episode -- a ghastly terror for someone so concerned with her feminine appearance!

You might ask at this point, then why wouldn't you just stop running? Well, I've never been a quitter for one. And my life has been hugely filled with obstacles, so many in fact that I've learned to turn them into learning experiences to make life better. This was one of those opportunitites. AND...I LOVE TO RUN! I love the fact that I'm 40 years old and am stronger and leaner than at any point in my life. I'm the same size as I was in high school and college. When I encounter most other female runners on my path, I can outrun them. And I have amazing energy throughout the rest of the day. I'm healthy and strong and I love it. Plus, I love the serenity of it -- the sun on my shoulders, the bunnies which hop across the trails, the cool breeze on my hot and sweaty skin, the volumes of sweat, the patterned breath -- all provide a serenity which allows me to work out the challenges of the day. I end the run more relaxed and sure of the day's path than when I began it. For every reason, I love it.

So on Thursday of this week, after having 3 "runners trots" episodes on an 8 mile run day, I decided to do more research. In the past my research had basically led me to "we don't know what causes it and so you'll just have to live with it" information. Because I figured that diarrhea needed to be tightened up and fiber adds fecal bulk, my approach had been to add more fiber to my diet. My diet, by all accounts was amazingly healthy. Here's what I was eating on a typical day:

1. oatmeal with a banana and walnuts (pre-run)
2. peanut butter and a banana (post-run)
3. baked oatmeal bar or veggies and protein
4. large salad with greens, chicken, wheat pasta, olives, feta and vinegar
5. veggies and protein
6. stuffed pita, popcorn, etc

I was getting all-natural fruit, veggies, protein, fats, etc, and as I mentioned before, I felt fabulous. Even though I was runing more than ever, I didn't feel fatigued, my body was recovering very well, I was hydrating enough to never feel thirsty, and my body fat was dropping a very slight bit each week which means my lean mass was totally intact as my weight remained the same.

But this time, my research hit on some good information. In fact, Nancy Clark, who is a well-known sports nutritionist had written an article on the subject -- Tips from Nancy Clark. Transit Troubles and Intestinal Concerns. After reading many others, I discovered that what she had to say, as usual, made the most sense and seemed to apply the most to me.

"More marathons are won or lost in the porta-toilets than at the dinner table" proclaimed marathon king Bill Rodgers while talking to a group of runners. You can fully understand the truth in that statement if you are among the many athletes who worry about unwanted pit stops, abdominal cramps or diarrhea. Transit troubles and gastro-intestinal (GI) concerns are surprisingly common among both athletes and non-athletes alike. An estimated 30 to 50% of distance runners experience intestinal problems related to exercise. The vast majority (83%) of 471 marathoners who completed a survey reported they suffered GI problems occasionally or frequently during or after running: 53% experienced the urge to have a bowel movement and 38% reported diarrhea. Women were more likely than men to experience these problems. Among 155 mountain marathoners, 24% had intestinal symptoms; 2 dropped out due to GI troubles. Dieters (including athletes--and those with eating disorders) are more likely than non-dieters to report abdominal pain, bloating, diarrhea and constipation. In a random survey of 2,500 Americans, 40% reported one or more digestive symptoms in the month prior to the interview: abdominal pain (22%), bloating (16%), diarrhea (27%). These problems were more prevalent than expected and more prevalent among women than men. Given the above data, we need to acknowledge this fact: bowel problems are a concern for many active people. Yet this topic is rarely discussed; few athletes feel comfortable discussing their dilemma with diarrhea. This article addresses this concern and hopefully can reduce your transit troubles.

How about that?!?! I'm not alone! I'm not genetically morphed! MOST longer-distance runners have this problem! Hallelujah! But there was more.

Many physiological facts help explain why diarrhea is a concern for athletes, particularly athletes in running-type sports: "jostling" of the intestines; reduced blood flow to the intestines as the body diverts blood flow to the working muscles; changes in intestinal hormones; altered absorption; dehydration. Add high intensity exercise, stress, anxiety, pre-event jitters, and little wonder athletes--particularly young and novice athletes whose bodies are yet unaccustomed to the stress of hard exercise--fret about "nervous diarrhea." Exercise--specifically more exercise than your body is accustomed to doing--increases intestinal activity. (Even strength training accelerates transit time from an average of 44 hours to 20 hours in healthy, untrained 60 year old men). As your body adjusts to exercise, you may resume standard bowel movements. But not always, as witnessed by the number of experienced runners who carry toilet paper with them during exercise, and also know the whereabouts of every public toilet on the route. To help alleviate the problem, try exercising lightly before the event to help empty the bowels. Experiment with training at different times of the day. Visualize yourself exercising with no intestinal problems; the problem may resolve with a positive mindset and experience. Fuel wisely; the following nutrition tips might help reduce the symptoms. 1) Reduce your intake of high fiber cereals. You don't need the roughage! Fiber increases fecal bulk and movement, thereby reducing transit time. Triathletes with a high fiber intake reported more GI complaints than those with a lower fiber intake. 2) Limit "sugar-free" foods such as sugar-free gum and hard candies that contain sorbitol. This type of sugar can cause diarrhea. 3) Keep a food & diarrhea chart to pinpoint food triggers. Take away any suspicious foods--excessive intakes of juice, coffee, fresh fruits, raisins, dried fruits, beans, lentils, milk, high fiber breads and cereals--for a week and then eat a big portion. Observe changes in bowel movements. If you stop having diarrhea when you stop eating bran cereal (but have a worrisome situation when you eat an extra-large portion), the answer becomes obvious: eat less bran cereal. To find the food culprit, you may need to look carefully at your prior diet, because food moves through most people's intestines in 1-3 days. A simple way to learn your personal transit time is to eat sesame seeds, corn or beets--foods that can be seen in feces. 4) Drink extra water to maintain hydration. GI complaints are common in runners who have sweated off more than 4% of their body weight. (That's 6 lb. for a 150 lb. athlete.) These same runners often believe the ingestion of fluid causes the diarrhea. The truth is the dehydration that occurs due to inadequate fluid intake is the true culprit. 5) When all else fails, you might want to consult with your doctor about occasionally using an anti-diarrhea medicine (such as Imodium). This may have side effects that hinder performance; be educated. The bottom line (so to speak): You are not alone with your concerns. By experimenting with different food and exercise patterns, you may find a welcome solution.

And...she offered detail on what to do to fix it!

After fully absorbing what I had learned, I did a fiber-analysis of the meal plan I listed above for you. Guess what? I was eating over 30 grams of fiber a day. And if runners have a higher turnover without the added bulk of fiber, I guessed that I was eating WAY too much fiber for being a long-distance runner and I changed my meal plan to:

1. small meal -- bar of some sort = 2-3 grams of fiber
2. mini-bagel, 1T PB, 1 banana = 5g
3. same salad with less wheat pasta, less fibrous greens = 5g fiber
4. plain, fat-free yogurt with fruit = 3g fiber
5. cooked veggies and protein = 2g fiber
6. cottage cheese and cling peaches = 0g fiber

And over the course of Friday, Saturday and Sunday, my 1st post-new-diet-run still met with the need to stop, but the need was less urgent and the volume was less.

The second post-new-diet-run met with a possible need (the fear of what may happen caused me to stop) to stop, but the volume was much less, the need was not urgent and the consistency was no longer diarrhea. Can I hear a "whoo-hoo?!?"

In short, in just 3 days I have met with marked improvement by going "against the grain" as it were. Although a high-fiber diet is a very important component of most people's lives -- the more sedentary, the more important, it isn't necessarily a good thing for runners who have a naturally higher turnover. By cutting my whole grains and fresh fruits and veggies bulk in half, my runs have been more concerned with the things that running concerns itself with -- not with a scared and prayerful mad-dash to find a bathroom.

I would like to thank Nancy Clark for changing my life in this manner. I am certain that over the course of several days with a dedication to planning, journaling and tweaking, that I can focus more again on how my shoes match my running shorts and how blue the sky is and how "I" decide when to run fast -- vs having to because I've lost control of my body.

Note: I added this next section 2 years after this article was written:

Question: Normally I would not spend any time on your site, but I am so thankful for having found your article "Going Against the Grain". I am a citizen athlete, solidly fit and able to manage my weight and exercise program.

I am also a vegetarian who thrives on a high fiber, high carbohydrate diet. I have a family history of, shall I say, bathroom urgency. I have inherited this trait, or so I thought. I have been seeing a gastroenterologist for three years, and, other than a little through a regime of drug taking which I detest on principle, have had little improvement. In fact, as I have been doing more running over the last three years, the situation has become worse. My incidents sound very much like yours were! From time to time I have searched for new information, but have found little. I have felt stuck with the no solution label of IBS. (Irritable Bowel Syndrome) Then I found your article a couple of weeks ago. Wow - did you ever hit the nail on the head. I am delighted to see familiar symptoms matched with a logical simple solution. First of all, thank you for documenting your situation. Second, thank you for enabling Google to find it!

Now, finally my question: I am trying to measure my fiber, but am struggling to find a good source. I am documenting all I eat and drink, my exercise and my GI reactions. I think I have been consuming over 50 grams of fiber most days. Now, sadly in some cases, I am revising what I eat. What I need is to be able to easily calculate fiber. Obviously a lot of food is labeled, but I don't eat a lot of processed food. Can you recommend a source? I am nervous about subscribing to anything on line as I don't want more SPAM, to be ripped off or other bad things. I would be quite happy with a good book. What do you recommend?

Answer: I found most of my very helpful information here: http://www.helpforibs.com which lists the correct "soluble" fiber that we need and with grams if I remember correctly. Also The Complete Book of Food Counts, 7th edition (Complete Book of Food Counts) has fiber listed for thousands of foods--but it doesn't break it down between soluble and insoluble.

I have unfortunately narrowed my problem down to produce--definitely most things raw except for bananas, and also cooked fruits and veggies if I eat too many.

My new, totally managed, diet is:

1. Eggs and 1/4 cup oats cooked with 1/4 cup unsweetened applesauce
2. Tuna salad with 1t chopped walnuts and 1/4 cup halved grapes on 1/2 a regular (ie not wheat) pita
3. Chicken with 1 cup steamed veggies and a roll or a potato or 1-2 cups pasta.
4. 2T soy nut butter on an apple cinnamon rice cake.
5. 1/2 cup cottage cheese and 1/2 cup yogurt.
   I snack on ginger snap cookies and almonds.

To try and keep my vegetable nutrients up without adding fiber, I also add 1 serving of a green powder in water each day and drink carrot juice from time to time. It's the fruit and vegetable and whole grain fiber that does me in (I won't touch anything "whole grain" any more). I also avoid lettuce, but sometimes add steamed baby spinach into my pasta, etc. This particular meal plan manages my symptoms perfectly!

Note it's the bananas, white pasta, white bread, potatoes, oats, rice, etc (what I used to avoid!) that bulk the colon and keep the bowels from "running." That, and a 1 mile run on the treadmill each morning to clear the bowels has my problem completely under control.

Good luck!