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How to avoid stomach problems while running

Updated on May 15, 2007

Many of us have experience stomach problems while running, ranging from cramps to diarrhea! So what causes this?? And how can we avoid it from happening??

A little stomach problem history

In 1982, a British physician named A. M. W. Porter developed a severe case of diarrhea as he ran his first marathon. This was hardly an earth-shaking event, but the bowel troubles did cause Porter to reevaluate what was happening to his internal organs during running. Porter eventually decided that his caecum, which is the first part of the large intestine, had been rubbing against the inside of his abdominal wall. This friction might have produced an inflammation of the caecum, precipitating the diarrhoea and causing stitch-like pain in the right side of the abdomen (where the caecum is located). Porter coined the term 'caecal slap' to describe the knocking of the caecum against the abdominal wall ('Marathon Running and the Caecal Slap Syndrome,' British Journal of Sports Medicine, vol. 16, p. 178, 1982).

This caecal slap may also be an additional source of stitches (see my HubPages article "Side Stitches"). Fortunately, the way to keep it from ruining your workout or competition is clear: breathe out when your left foot hits the ground, not during right footstrikes. If you breathe out when your right foot hits the ground, your abdominal wall will move inward at the same time that your caecum, which is also on the right side of the body, is jostled, maximizing friction between the two body parts. In general, being a 'left-footed exhaler' is a good idea if you know that you are a right-sided stitcher. Left-footed exhalations should also help to minimize the tension between liver and diaphragm which we described earlier.

It's possible, too, that marathon-type endurance runners could reduce the risk of developing a colon-slapping stitch (and perhaps stitches of all kinds) by deliberately changing their breathing patterns every now and then. The idea would be to use left-footed exhaling most of the time but to shift over to right-footed exhalations for five- to 10-minute periods during races and long workouts. This should lead to more equal 'bruising rates' on each side of the colon and diaphragm and might help thwart stitches by reducing the possibility of a significant irritation on one side of the body.

There are many other factors which increase the risk of stomach problems while running. Fast running is more likely to start a problem than slow, because fast running features higher ground-reaction forces and more dramatic and quicker movements of the diaphragm. Running on rough, hard ground also raises the risk of stomach problems, compared with pacing along on even, softer surfaces. Being out of condition can dramatically hike your risk of problems, as can starting out too fast in a competition.

What to do

Avoidance of chest-only breathing and an overly tight diaphragm is also extremely important; your diaphragm should feel like a large flap of rubber, and your stomach should move outward like a balloon when you inhale. If you strengthen and relax your diaphragm, breathe properly, fortify your abdominal muscles, warm up thoroughly prior to workouts and competitions, and refrain from dining and drinking more than you can handle before you exercise, it's very unlikely that stitches will limit your training or performances.


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