That all changed around Thanksgiving, when she started experiencing stomach pain and other digestive symptoms that left her running to the bathroom three to five times a day. Within three weeks, her health took a turn for the worse, and she found herself going to the bathroom more than 30 times a day. “I was unable to eat and had no energy,” Harrison says. “I honestly thought I might die.” In December of that year, Harrison sought medical help and was soon diagnosed with ulcerative colitis (UC), a form of inflammatory bowel disease (IBD). “The doctor told me my entire colon was inflamed and my case was very severe,” she says. After Harrison started her treatment plan — biologic infusions every four weeks, plus a daily maintenance medication — she got right back on the trails, and in summer 2020, she completed the intense, 100-mile Nike Trail Challenge, which is accomplished over two months. “There were times I had to cut my workout short, because I needed to run to the bathroom after only 0.1 miles,” she says. Even so, Harrison completed the challenge ahead of schedule, in less than 8 weeks. Like Harrison, other runners who have UC struggle at times. But she is proof that it can be overcome. Here’s how.
1. First, Get Your Colitis Under Control
“If you’re newly diagnosed with ulcerative colitis, my recommendation would be to put the running on the back burner and the UC on the front burner,” says Noah St. John, ACSM, a certified exercise physiologist and registered dietitian at Duke Health and Fitness Center, in Durham, North Carolina. Take time to figure out what your food triggers are, map out a medicine routine with your GI doctor, and keep a food journal before starting or returning to a running regimen, says St. John. Longtime runner Michael Steck, an ACE-certified health coach who has UC, tells runners to watch what they drink pre-run. “Hydration is a huge challenge, especially if your symptom is diarrhea,” he says. For shorter runs, Steck recommends avoiding sugary sports drinks, because sugar pulls water into your small and large intestines and could trigger GI issues. Instead, Steck recommends electrolyte-infused waters, which have no added sugars and help hydrate the body. For runs that span over an hour, though, sports drinks such as Gatorade can help you replenish your electrolyte levels and supply your body with simple sugars you can absorb for extra energy, he says.
3. Fuel Up a Few Hours Before a Run
“If you’re going to eat a full meal comprised of the three macros — carbs, lean protein, healthy fat — which is what I recommend, do that no sooner than two hours before a run — and three hours is even better,” says Steck. The reason: After a meal, there’s an increase in blood flow to your digestive tract. But during a run, that blood goes to your leg muscles instead, away from your digestive tract, Steck explains. When that happens, you may experience cramping, nausea, and diarrhea. “It’s best to get that full meal in a few hours before [a run] to give your body ample time to digest the food with minimal interference,” he says. Dr. Barto recommends high-protein foods, such as Greek yogurt, which is also low on lactose. “A lot of this comes down to listening to your body,” adds Steck. “I do believe that the body is your best source of information when it comes to deciding what’s best to do. Every patient should know their trigger foods and what foods tend to bother them.”
5. Buy an Ostomy Bag for Runners
Today, ostomy bags come in a variety of options, especially for runners, says St. John. “Consider one that has a waist belt with a water bottle, so you can take small sips [of water] throughout your run,” he says. There are also bags specially designed so they don’t chafe during your run, he adds. “Some people tape cloth over their bags so that the rough plastic edge isn’t rubbing,” says St. John. High-waisted athletic pants and tight-fitting running shorts can also help keep ostomy bags in place.
6. Find an Alternative
During a flare, Harrison wasn’t able to run, but she was able to do other forms of exercise, such as hiking, biking, and walking. “I pushed myself with distance and elevation and didn’t worry about speed,” she says. Harrison hasn’t been able to complete a marathon in one shot since her diagnosis. “My longest [single] run this year was just over 9 miles,” she says. But she has been able to hike more than 26 miles.
7. Be Selective About Pain Meds
If you have an injury during a run, you shouldn’t take nonsteroidal anti-inflammatory pain medications, such as ibuprofen, because they can cause an IBD flare, says Barto. Instead, try taking acetaminophen and relying on therapies such as stretching, heat, ice, and massage.
8. Be Prepared
There’s nothing worse than having a flare during a run when you’re nowhere near a bathroom. Harrison recommends stashing some supplies, such as wet wipes, in a running belt. “If you have an ostomy bag, be prepared to have supplies on hand to clean that out while on a run,” says St. John.
