Cycling with IBS is manageable and enjoyable by taking control of your gut.
When cycling with IBS, you feel like your bowels are a fermentation tank, and you stir things up each time you turn the pedals. As you take a sip from your bidon or bite a bit of a power bar, you’re adding fuel to the ferment fire. The poorly digested carbohydrates pass through your small intestines into the large, and that’s when a cyclist with IBS realizes their nightmare.
Bacteria in your gut are whipped into a frenzy, releasing gas in the form of flatulence, farting, and oops. The outward embarrassment to the unfortunate rider on your wheel is only a tiny signal of your internal torment. Your attempts to hold it in cause bloating that stresses the bowel wall.
Your body tries to extinguish the fire by flushing your gut with water. Then the question every cyclist with IBS asks themselves before and during every ride. How far can I safely ride from the comforts of home, and will I make it in time? Only your gut knows as the fluid influx loosens things up even more. Yes, the D word, diarrhea, is propelled by the pressure of your full abdomen and bloated gut.
Cycling with IBS, irritable bowel syndrome, is no picnic, but it doesn’t have to flush away your enjoyment.
What is Irritable Bowel Syndrome (IBS) When Cycling?
Irritable bowel syndrome (IBS), also called spastic or nervous colon, or spastic bowel, is a gastrointestinal disorder with a spectrum of symptoms that include abdominal pain and changes in the consistency of bowel movements. Symptoms build up over time, often years or more.
Healthcare professionals classify IBS into four main types based on common symptoms of diarrhea (IBS-D), constipation (IBS-C), both or mixed/alternating (IBS-M, IBS-A), or if neither frequently occurs (IBS-U).
IBS is a significant quality-of-life issue affecting all aspects of daily function and recreation, including cycling. Individuals suffering from IBS experience anxiety, depression, and chronic fatigue. IBS is often a challenge for cyclists because the cause is unclear.
Theories range from digestive tract motility disorders and bacterial overgrowth to genetic factors, food allergies, and sensitivity to certain foods. Intestinal infection or stressful life events triggers the onset in many. Identifying IBS, modifying predisposing factors, and making lifestyle changes are the keys to enjoying a life of cycling with IBS.
How Common is IBS in Athletes?
Irritable bowel syndrome is an insidious gastrointestinal condition affecting 5-10 percent of the worldwide population. IBS affects almost 45 million Americans, 66 percent female, and most are under 50.
According to a study published in Applied Physiology, Nutrition, and Metabolism (Killian et al. 2019), IBS is underdiagnosed and ineffectively managed in endurance athletes. Symptoms of IBS are common in the athlete population and can significantly impair performance.
2.8 percent of endurance athletes have been medically diagnosed with IBS, but that doesn’t tell the whole story. Fifty-six percent of athletes questioned reported IBS symptoms that interrupted or prevented training 18.6 percent of the time.
However, only 47.6 percent consulted a medical professional. Over half of the endurance athletes admitted to trying nutritional modifications and many turned to over-the-counter medications.
IBS when cycling is a common condition that negatively affects performance and enjoyment.
Symptoms and Diagnosis When Cycling with IBS
When individuals cycle with IBS, they experience abdominal cramps, bloating, diarrhea, constipation, and pain. While these gastrointestinal symptoms are shared by many, those with IBS experience them more frequently and intensely, causing them to interfere with day-to-day living.
In a study of over 2,900 IBS sufferers, 31 percent reported experiencing severe pain during the past three months. Pain occurs when the material in the gut passes through at different rates. Spasmodic bowel contraction impedes the passage of gases causing painful pressure and bloating. IBS sufferers often have a rapid, intense reaction to gut pain that occurs after eating and can last for hours.
Up to 20 percent of IBS patients report bowel movement symptoms. Many have urgency, while others strain during bowel movements and convey a feeling of incomplete evacuation. Signs often come on fast and can last several days.
There are no conclusive lab or diagnostic tests to diagnose IBS. The random, inconsistent, and unpredictable symptoms make the condition challenging for cyclists with IBS. Cyclists must always think about their gut’s behavior, leading to anxiety and stress. It impacts them throughout their daily life and recreation.
Cyclists skip meals before a ride because they don’t want to lose control. Many will neglect much-needed nutrition during a ride for the same reason. Others will map out every toilet opportunity. In extreme cases, cyclists will limit their outdoor riding or entirely avoid it.
Exercise is Beneficial For Cyclists with IBS
In many cases, experts have shown that exercise mitigates IBS symptoms. Physical activity stimulates the digestive tract to help pass material and decrease food and gas transit time. IBS patients who engaged in cycling, walking, and swimming 20 to 60 minutes three times a week for 12 weeks significantly reduced symptoms.
A 2020 Digestive Diseases and Sciences study showed that yoga improved digestion and reduced IBS symptoms. A 2020 PLoS One study found a direct correlation between the more steps walked per day and symptom severity. The researchers believe walking aids digestion, relieves constipation and aids in the movement of gasses through the gut.
A study published in the World Journal of Gastroenterology pointed to cycling as a factor in improving the overall health and long-term symptoms of IBS sufferers. In addition to the general exercise benefits, the researchers felt that cyclists could vary their intensity to symptom level.
Cycling is a good choice when acute symptoms of IBS, such as diarrhea and abdominal pain, make it difficult for a patient to exercise. When symptoms decrease, exercise is an essential beneficial addition and can help prevent and manage future symptoms, but it isn’t always the best idea.
Not all Exercise is Good For IBS
Some exercise will trigger IBS symptoms and should be modified or monitored to avoid making cycling with IBS worse. Many cyclists and endurance athletes will incorporate cross-training into their programs. Although popular, the intensity and hardcore nature of CrossFit can worsen IBS.
The repetitive pounding and impact of running can result in abdominal cramping and diarrhea. Runner’s diarrhea, or Runner’s trot, is a common and unexplained phenomenon with symptoms similar to IBS.
In many cases, it’s not only the type of exercise contributing to IBS symptoms. High-intensity exercise interval training (HIIT) can cause digestive stress due to the repetitive maximal effort of vigorous exercise.
In general, exercise is an effective way to control IBS, and individuals shouldn’t avoid it. It’s important to progress slowly and monitor your response. Being active and regularly exercising is a proven method of IBS management, but all athletes must know their limits and be realistic in their expectations.
Prevention, Treatment, and the Best Diet When Cycling with IBS
If you’re a cyclist with IBS, then the term FODMAP has come up during your group ride stop at the coffee shop as you reached for the chocolate milk. FODMAP, which stands for fermentable oligo-, di-, mono-saccharides, and polyols, are short-chain carbohydrates that are more difficult to digest and cause a cyclist’s stomach to flip.
Common FODMAPs foods a cyclist with IBS should reduce or avoid are fruit, dairy products, wheat, and barley. By restricting the amount of FODMAP foods, athletes control and reduce their IBS symptoms within two weeks, but it varies. FODMAP is not a forever plan. However, it has been shown to help over 70 percent of IBS sufferers find short-term relief and a long-term solution.
In basic terms, the FODMAP protocol has two phases and can be an effective treatment when followed. In phase one, an athlete will restrict or eliminate foods that fall into the dietary category for around eight weeks. The athlete’s symptoms will improve as the gut relaxes and heals and begins to regain normal function.
In the second phase, cyclists with IBS will systematically and slowly reintroduce themselves to FODMAP foods. By monitoring the body’s response, an athlete determines the FODMAP culprit. From there, they develop a list of foods their gut can handle to prevent further symptoms. A cyclist with IBS should look to a dietician for guidance because a restrictive FODMAP diet causes detrimental side effects in extreme and prolonged cases.
Creating a Food Log When Cycling with IBS
It’s helpful for cyclists with IBS to create a low-FODMAP diet journal. The systematic approach to documenting the foods that trigger your symptoms will equip the athlete cycling with IBS to make better choices. There is no one-size-fits-all to food journaling, but it’s essential to observe the following and include it in your entry.
- How did you feel when you woke up?
- What did you have for breakfast, and how did you feel after eating?
- How did you feel in the time between breakfast and lunch?
- What did you have for lunch, and how did it make you feel?
- How did you feel between lunch and dinner?
- What did you have for dinner, and how did you respond afterward?
- How did you feel during the time before going to bed?
- If you had any snacks, ask yourself the same questions as above.
In addition, keep track of your bowel habits and describe them the best you can. Write down details about your stool, including stool consistency, stool looseness, and if you have bloody stools. If your journaling makes you eliminate food that you’re reacting to, include it in your journal.
The information may not seem significant at the time. However, it will offer valuable insight and a wealth of information for healthcare professionals in the future.
How to Fuel When You Have IBS When Cycling
Athletes and cyclists with IBS that engage in extended-duration endurance events may find it challenging to tolerate sports drinks, gels, bars, or snacks during exercise. The challenge is that endurance athletes need carbohydrates for fuel, and many FODMAP foods fall into that category.
While there are specific cases when a low-carb and high-fat diet improves performance after adaptation, optimal adequate carbohydrate intake generally improves performance. Here are some FODMAP-friendly alternatives.
Low FODMAP Snacks
You can eat some banana chips, gluten-free pretzels, a few rice cakes with nut butter, rice crackers and hummus, and most nuts, among other acceptable snacks.
Fruits like grapes, blueberries, raspberries, cubed cantaloupe, kiwi, and unripe bananas are good choices.
There are a few commercially-produced FODMAP-specific products, like the Fody low FODMAP granola bar, the FODMAP Everyday homemade granola bar, and the Bobos Bar (safe flavors: chocolate chip oat, maple pecan oat, original, peanut butter oat, and peanut butter chocolate chip oat). You can also look for bars from companies like GoMacro (choose their nut-free bars) and Rachel Paul’s Happy Bars.
How To Choose A Low-FODMAP Sports Product
Avoid the following high-FODMAP ingredients when searching for a sports nutrition product for on-the-bike fuel. If the label reads the following, do further research and monitor your symptoms.
Be on the lookout for agave, honey, Xylitol, Sorbitol, Mannitol, Maltitol Isomalt, Inulin, large amounts of coconut water, and concentrates from high FODMAP fruits or vegetables(apple, pear, cherry, mango, peach, beets, watermelon, etc.)
Avoid high-fructose corn syrup, although most athletes will tolerate ingredients with equal glucose: fructose ratio. Fruits and foods containing large amounts of sugar (fructans) may cause digestive issues if consumed too frequently.
There are other ingredients that aren’t technically high-FODMAP but may cause IBS symptoms. The list includes Carrageenan, Guar gum, Acacia gum, and Xanthan gum. Some athletes respond poorly to artificial sweeteners like Sucralose and Aspartame.
Caffeine can increase GI symptoms in some individuals, even if they aren’t cyclists with IBS. Before fueling your next ride with a caffeinated sports drink, test your reaction first. Caffeine may have a performance-enhancing effect, but it won’t help if you’re in the bathroom and not on the bike.
For more great information on the topic of fueling, check out fodmapeveryday.com.
The Stress and IBS When Cycling Cycle
Cyclists with IBS don’t only have their sensitive gut to deal with; the psychological response to stress and mental health is a significant factor. Cyclists can fall into a stress-IBS cycle. It might seem more manageable and more comfortable for cyclists with IBS to avoid riding outdoors or with others.
The coping avoidance mechanism is effective in the short term and can have negative long-term consequences. It doesn’t address the underlying problem making us anxious if the situation arises again. The cyclist who only trains alone at home will never confront their fears and will forever live a solitary cycling life.
The stress-IBS cycle causes the cyclist to miss out on meeting new people and experiencing the wonderment of beauty of cycling. The universe for cyclists with IBS shrinks if they don’t take control of their gut symptoms.
Avoiding the local group ride or training with a friend for fear of bowel urgency or abdominal pain that may not occur makes it easier and easier to avoid in the future. Before long, the cyclist is in a downward stress-IBS cycle spiral that they can only stop by taking charge of their mental health.
Now that you know how “everyday” cycling with IBS can be, there’s a good chance one of your cycling friends suffers from the chronic condition. IBS is a challenge to identify and manage, yet cycling at a high level with IBS is possible with careful monitoring and lifestyle modification.
Unlike endurance sports, like running, where systemic changes redirect blood from the gut to the muscle and upset the digestive system, cycling moderates IBS symptoms and improves outcomes. Cyclists with IBS must learn to confront their anxiety and take control of their gut.
They’re not the only ones with the issue, and no one minds taking a bathroom break now and then. Non-IBS sufferers can lend a hand by easing the apprehension of their friends cycling with IBS by announcing toilet stops, overlooking food choices that seem unusual, and not being critical or judgemental.
Cycling with IBS doesn’t have to be a prison. On the contrary, cycling positively affects gut health and can be a powerful motivator for maintaining a healthy lifestyle and adhering to a proper diet. Don’t let cycling with IBS flush your enjoyment down the toilet.
What's the poop?
Do you or anyone you know suffer from cycling with IBS? What works? What doesn’t? Comment below! Your fellow cyclists want to know.
Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!