Fixing problems in Ultramarathons

The table below lists some of the possible problems you may encounter during an ultramarathon, along with possible causes, treatments and preventions. Continuing a race when you have a problem entails some degree of risk, and these problems can impair your judgment, so use caution. This list is not comprehensive, and is expected to change over time. With all these suggestions, never forget The Golden Rule of Racing, "Never do something in a race you have not practiced in training".

Symptom	Possible Cause	Possible Treatment	Possible Prevention
Nausea/Vomiting/Stomach ache	Overeating	Reduce calorie intake Ginger or mints may help	Eat what appeals
	Going too fast	Slow up, possibly dramatically until things improve	Better pacing
	Excessive fluid intake	Reduce fluid intake	Drink to thirst
	Too much salt	Restrict salt intake Be careful with Electrolyte Capsules to balance them against fluid intake.	Balance salt intake with fluid intake Avoid Electrolyte Capsules
	NSAIDs	Avoid NSAIDs	Avoid NSAIDs
	Infection	Sorry, better luck next time	Careful hygiene, including keeping all your drinking containers sterile
	Change in intestinal bacteria (due to traveling)	Sorry, better luck next time	Travel earlier Avoid non-bottled water.
	Constipation	Higher fiber intake Stay hydrated	Higher fiber intake
	Tight waist band	Loosen anything around your waist or pressing on your abdomen	Avoid whatever caused the pressure
Fatigue/sleepiness	Low blood sugar	Take something sweet or a Gel	Take carbs earlier
	You're running an ultra (what did you expect?)	Caffeine Short nap (5-15 min).
	Thinking about the time	Ignore the time of day and focus on the hours
Depression	Low blood sugar	Take something sweet or a Gel	Take carbs earlier
	You're running an ultra (what did you expect?)	Music Positive thinking Keep moving and wait for it to pass Have a good cry Play mental games Don't think about how far you have to go Count the miles down rather than up Mentally hook a runner in front and let them pull you along Join up with another runner or group of runners
Headache	Low blood sugar	Take something sweet or a Gel	Take carbs earlier
	Tight hat	Loosen hat	The Golden Rule of Racing
	Lack of sleep	Short nap
	Caffeine withdrawal	Take caffeine	Monitor caffeine intake Consider abstaining from caffeine for 1-2 weeks before the race
	Overheating	Slow down or stop Remove excess clothing	See Running in the Heat
	Dehydration	Drink more Keep salt intake high Slow down or stop	See Practical Hydration
	Altitude sickness	Viagra for Altitude Descend	Altitude training Viagra for Altitude
Heartburn	Eating 'wrong' foods	Antacid tablets Eat what appeals Avoid what triggered the heartburn	Avoid what triggered the heartburn
	Stress	Try to relax	Visualization Preperation
Blisters	See Blister Prevention	Taping	See Blister Prevention
Bloating or gas	Overeating	Reduce calorie intake Gas-x	Eat when hungry
	Eating beans or other gassy foods	Gas-x	Change diet before and during the race
	Antibiotics	Gas-x	Take yoghurt to help compensate
Diarrhea	Infection	Consider Imodium	Careful hygiene
	Gastrocolic reflex	Some foods are a stronger stimulus of this reflex, so avoid those foods	Avoid triggering foods
	Too much fiber	Consider Imodium	Carefully reduce Fiber intake before the race
	Change in intestinal bacteria (due to traveling)	Consider Imodium	Travel earlier Avoid non-bottled water.
	Too much isolated Fructose	Stop Fructose intake	Avoid foods high in fructose
	Dairy (lactose intolerant)	Stop dairy intake (read the ingredients)	Avoid dairy
	Ischemic colitis	Stay hydrated	Stay hydrated
Antibiotics	Sorry, better luck next time	* Take yoghurt to help compensate
Weak legs	DOMS	Caffeine	Downhill Running
	Glycogen depletion	Take something sweet or a Gel Increase carbohydrate intake Caffeine to increase carbohydrate absorption	Carbohydrate Loading
Cramping	Sodium Deficiency	Add salt to your drink Eat something salty Drink pickle juice	Fellrnr's Go Juice
	Muscle fatigue	Stretching	Stretching Relaxed running form
Chaffing	Skin on skin	Wear something form fitting so the clothing rubs, not the skin Tape both surfaces so the tape is rubbing, not the skin Lubricants may help if used early enough, but often make things worse	Wear clothing that prevents the chaffing
	Skin on clothing	Wear something form fitting so the clothing rubs, not the skin Tape the skin Lubricants rarely work	Wear clothing that prevents the chaffing
	Monkey butt	Clean the area using moist wipes, making sure it's really clean. Any unwanted residue will act as an abrasive. Diaper (nappy) treatment can help relieve the pain. Destin is recommended by some runners, but does have a strong odor. Lubricant can help if used early enough, but if the skin is damaged and rough it doesn't help as much. One of the best lubricants for this area is 2Toms Sport Shield. You either need a roll-on dedicated to this area, or preferably use the Sport Shield Wipes.	Cleanliness is critical. Make sure the areas is thoroughly clean, using wet wipes if you have to go mid-race. Lubricate before the race, clean and lube after you go and periodically through a longer race.
Fainting, or near fainting (light headed, dizzy)	Heart problems	Fainting or near fainting can be a warning sign of a serious health problem and it may be the only symptom that precedes a sudden cardiac death.
	Dehydration	Drink more Keep salt intake high Slow down or stop	See Practical Hydration
	Stopping suddenly	Slow up before coming to a stop
	Hypothermia	See Hypothermia.
	Altitude sickness	Viagra for Altitude Descend	Altitude training Viagra for Altitude