Nausea & Throwing Up

[Chris Hyatt]

With all humility, I am looking to solve a problem that has plagued a number of my hikes. I am not looking for detailed bio-physics of the human metabolism as I have seen in other threads. I can't follow all of that stuff. :) I am just looking for some thoughts on what you think the cause is and what I might try.

So here goes:

I tend to over exert myself on the trail. Generally speaking I do 15-20 miles a day (which is a lot for me) and the uphills pretty much kill my legs – but I press on. Shortly into my hikes, I lose my appetite for food – even for the most decadent candy or junk food. Then comes the nausea. Generally speaking this makes me even less inclined to eat or drink anything which probably compounds my exhaustion and nausea even further.

Usually it doesn't get any worse than that. I stop hiking for the day, the nausea goes away, but I take in very little in the way of calories because I just don't feel right until the next morning. Sometimes, however, if I eat anything solid shortly after or during a hard hike, I will throw it up. I can, however, continue to hydrate without a problem but still remain nauseous until I have had a significant rest (usually overnight) but still not much of an appetite.

Obviously this issue causes me to become further dehydrated and leads to a very unpleasant hiking experience.

My thoughts are that I am either not hydrating enough or not taking in enough carbs for the activity I am engaging in, but there's the rub – I nauseous and don't want to eat.

Thoughts on what might be the issue and what I can try?

[BlackHatGuy]

slow down and stop over exerting yourself until you condition your body better. Not saying you're out of shape or anything like that, just that your body isn't conditioned to excessive exertion. so slow down, do shorter hikes and then build back up, only build back up with the ability to hydrate and eat during the hike.

[Chris Hyatt]

Thanks Doug. I am sure you are right about needing to condition myself better prior to taking on hikes like the White Mountains and Trans Zion Trek. Unfortunately I'm in IT (desk jockey) and a flatlander here in Florida so I only get occasional (4-6 times per year) hikes in the mountains which makes it difficult to simulate those conditions regularly.

I need to think about a way to really get myself in better condition despite these limitations. Throwing on a 25lb pack for a 1 hour elliptical run ain't cutting it.

[Alexander S]

Your symptoms are those of overexertion and hypoglycemia. Being dehydrated doesn't help.
The only thing to do is take breaks, eat carbs and hydrate along the way.

[Valerie E]

I'm with Doug on this one.

Your symptoms are very common for folks who push themselves way too hard/long/fast — your body is telling you clearly to slow down, and you're telling it to go fck itself. It doesn't take that kindly.

I'll bet you're a "Type A" personality in other aspects of your life, too! ;^)

Seriously, just slow it down a LITTLE bit; enough so that you could have a decent conversation while hiking (without panting), and I'll be willing to bet that your nausea disappears completely!

[Chris Hyatt]

You nailed it Valerie – definitely Type A – Git-r-done!

I'm usually not out of breath when I am hiking though and can have a reasonably conversation with folks while I am hiking. That's why I am a bit more inclined to think it is low blood sugar.

Any thoughts on an easy way to stay fueled without having to force feed myself? I saw some folks talking about Malto and mixing that with water. I was also thinking about using clif shots or something like that which would be easy for my body to digest.

[Valerie E]

OK, Mr. Type A (hehehehe)…

If you like the taste of sports gels (remember to drink lots with them), that would probably work. You might even try something as simple as gummy candies (if you like them) — there are some made of real juice, if you're trying to be a bit healthy. Super-easy to pop some into your mouth as you hike (keep 'em in a pocket)… I'm not above doing that myself, since I tend not to like to eat while hiking.

[Bob Gross]

Once I am hiking for any period of time, most of my blood is devoted toward servicing my large muscles. As a result, there isn't much left to go for digestion starting at the stomach. If I eat anything more than a half candy bar, it will just sit in my stomach until everything catches up and I am resting in camp. So, I eat extremely little solid food while out on the trail. But I still have to get some water and some energy, so I go for sports drinks. Sometimes I will have some Gatorade to use up, but more typically it is some maltodextrin-based stuff. I have the sports drink in one bottle, and plain water in the other bottle. If I am out on the trail for a while and just get dry, I can drink the plain water. But if I am out for another while, I will feel tired unless I get a hit of the sports drink.

I find myself in too many places where I simply cannot stop and rest. Either I have to get up over the pass and down, or I have to beat the approaching storm to my camp. So, I try to keep enough liquid energy intake to keep going at a moderate pace.

If I got up to some 13,000-foot pass and ate 500 calories of solid food, my body would probably be recovered there days later.

–B.G.–

[Roger Caffin]

> Once I am hiking for any period of time, most of my blood is devoted toward servicing
> my large muscles. As a result, there isn't much left to go for digestion starting at
> the stomach. If I eat anything more than a half candy bar, it will just sit in my
> stomach until everything catches up and I am resting in camp.

As Bob said.

Also, when you are straining your guts too much, just as you have described, it can take up to an hour before your stomach can handle food.

Such nausea is also commonly experienced by some long-distance runners, especially when they are not very fit.

Great will power – but not so great brain-power. :-)

Cheers

[John Klinepeter]

Chris,
I have been experiencing the same problems you listed, though not so much the nausea. It has gotten worse over the years. This summer there was a BPL thread in which one of the posters mentioned constantly consuming candy or sugar to keep himself going. I tucked that suggestion into the back of my feeble brain and started following that advice two or three months ago. Guess what? It works amazingly well for me. It eliminates much of the tiredness and dulled thinking at the end of the day and seems to promote hunger at least somewhat. What is startling is that the amount required to keep me going is very small–as little as 100 calories spread out over the day for a 12 mile hike. Of course I eat a lunch, too. I hear you on the "force feeding" aspect. My normal eating pattern at home is to consume two or three meals per day with little or no snacking in between. Trying to carry this feeding technique into the back country just does not work any more (I could do it when I was younger). My candy of choice has been SweeTarts; I can suck on them all day without getting tired of them.
Thank you to the earlier thread posters. Your names have been forgotten but your advice was spot on.
On a side note I have found that the consumption of an electrolyte tablet dissolved in water is less effective than eating the carbs. That could just be me, though.
I have no connection to Nestle or SweeTarts (love those disclaimers!).

[Katherine .]

Yeah, screw the nutrition, sometimes you just need the quick and easy calories.

I'm quick to puke in general. Had a hard time of it on a group trip last spring. So I can at least commiserate.

[Anonymous]

Yeah, i've noticed that one of the only foods i can eat in careful moderation while active is brown rice crackers and chewed/salivated extremely well. It has a nice balance of providing some initial, fairly quick blood sugar spike, but also a bit of a prolonging/steadying as compared to straight up refined sugar.

No "proof" of same, just experience with it.

[Dale Wambaugh]

The first thing that came to mind was electrolytes and staying hydrated, drinking a little often rather than big gulps when you're toasted. Maybe experiment with different electrolyte mixes?

Ginger really does help with nausea and it's easy to mix some candied ginger in with trail mix. My wife likes it in tea too.

I've found that biking helps to keep my legs in shape and it seems easier to go for a long bike ride than a short walk. Florida must be cycling heaven– the Netherlands with good weather :)

Is altitude a factor?

Definitely stop and smell the roses. It's enough of a rat race in civilization!

[Bill Segraves]

How long does it take for your nausea to begin, either in miles or in hours?

Do you get the same symptoms in that time/distance on a hike at comparable exertion levels when you're at home?

Cheers,

Bill S.

[Matthew Frye]

Just want to toss this out there, and I doubt it's something anyone here has to worry about. Mostly a word of caution that issues relating to the stomach are not always what we think. (Then again, I just went through hell so I'm extra sensitive to the issue)

This year I thought I was having a similar issue, but it kept getting worse. One day the symptoms didn't subside after rest when in camp and it became so acute emergency services had to be called to take me off the mountain to the local hospital.

It was terrible, I was crying and begging for help before some of the other hikers in the area came to assist. I consider myself pretty hardened but never experienced something like that in my life.

To make matters worse, when I arrived at the hospital they automatically assumed it was a water born illness, gave me some fluids and a script for antibiotics before sending me on my way. Being to sick to go on I had someone pick me up and drive me the 3 hours back home but before we could make it I fell very ill again and had to check myself into the nearest ER where the exact same thing happened. Fluids, and a script.

It wasn't until that evening when 911 had to be called yet again and I was shipped off to Hopkins that the real problem was discovered. A mass had developed in my digestive track. Thankfully for me the problem was able to be treated during a two week inpatient stay and almost unbearable amounts of pain and discomfort. In the 3 months since this happened I've made almost a full recovery, with only some minor discomfort remaining but the knowledge I'll make a full recovery makes it kosher in my eyes.

If I ever have another issue relating to digestion and need to see a physician I'm going to do anything I can to keep the fact I backpack from them. They seem to just make assumptions based on that fact alone.

In conclusion, stomach issues suck.

[Nico .]

I don't know what the cause of your ailment is, but if you can't get solid foods down or digest them during exertion and you still want to get some calories in your system throughout the day, I'd look at some of the sports drinks mixes marketed toward endurance athletes. These mixes often contain combinations of carbs, electrolytes and proteins/amino acids, with different concentrations of these additives depending upon the nature/duration of your "event" (i.e., more carbs for shorter events up to ~4 hours, mix of carbs and amino acids for events extending to 6 hours or so, and more protein for the longest 6+ hour events). Many of these drink mixes are only mildly flavored or sweetened so they're easy to drink without causing problems of their own.

I've had similar problems to you during long distance (~30+ miles) ocean paddling races that take 5- 6 hours to complete. I have real trouble getting solid foods down or even feeling hungry, yet obviously need to get some calories back in me to continue on. I've had great luck with the drink mixes made by Suceed. They follow my above-described protocol. Suceed mostly caters to the ultra marathon crowd, but it has worked well for me in other endeavors like paddling or mountain biking. I can use the Suceed drink mixes by itself or doctored up with some additional electrolyte and/or carbohydrate (Carbo-pro) supplements to get me through these long distance races without any solid foods.

[Anonymous]

"I need to think about a way to really get myself in better condition despite these limitations. Throwing on a 25lb pack for a 1 hour elliptical run ain't cutting it."

Find a gym with a Step Mill and climb up on it with that pack. It is far superior to an elliptical trainer, Stairmaster, or even treadmill, and a great way to gain the kind of fitness you'll need for mountain hiking, IF you can't find a hilly place nearby to hike. Also, could you make it up to the AT for weekend conditioning hikes, at least part of the year?

Other than that, +1 to what Doug said. There aren't any dietary fixes to your problem. Until you get yourself in shape, you're only going to have miserable experiences and possibly get yourself in serious trouble.

+1 to the sports drink suggestions while you are getting yourself in better shape, but they are not a magic bullet, nor will they make up for insufficient fitness for the hikes you are doing.

[D M]

try

Hammer Nutrition Perpetuem Endurance Fuel

I use it when I can't keep solid food down. My niece who is an Olympic skier turned me on to it, she has a hard time eating before and during
Events and loves the Hammer and Heed products. Mixes easily with water, I use a ziplock twist and lock storage container.

[John Almond]

I had similar problems on a trip two years ago.

A VERY long day (for me, at the time) with more elevation change than I was used to, hiking with a much stronger hiker, 104* F temperatures, and not enough water/food contributed to me losing my lunch on the side of the Foothills Trail in SC. At that point, my hiking buddy called the hike and we headed back to town. Which was exceptionally disappointing to me, but I saw the wisdom in it.

Flash forward a year, and I managed the same hike with a similar load with no problems whatsoever (well, at least not with my stomach; my knees were pretty done by the end of my thru). Admittedly, the temperatures were much lower, but the main difference was my fitness level.

I spent the intervening year doing between three and five hours at the gym each week, focusing on Olympic lifts, running an average of ten to twenty miles a week, and biking an average of seventy miles a week. The work really did make a difference.

Spend the time at home (plan on an hour a day of going hard five to six days a week), and the trail will be much easier.

In the meantime, scale back your pace and distance on your trips. You'll feel much better on trail and enjoy it more.

Hope it helps!

[Sean Westberg]

Considering that you're in IT (I am too and I suffer from sitting all day), see if you can convert your workstation to a standing station. My boss has done it and I'm considering doing it and really it keeps you up and moving a *lot* more than planting your rear in a chair for 8 hours or more a day.

If I could afford it, I'd totally get one of those treadmill workstations and just kind of stroll at half a mile an hour while I work.

[Art …]

" Such nausea is also commonly experienced by some long-distance runners, especially when they are not very fit. "

nausea from pushing hard is also commonly experienced by long distance runners who are very fit elite runners.

this reaction is not simply a matter of fitness level.
it is a reaction to your exercise intensity level and your bodies ability to react/adapt to it. fitness may help push this limit a bit higher but not eliminate the nausea at your limit.

overall intensity is a function of both pace and distance.

simple solution, slow down, take it easy.
you'll be able to go farther.

[Bill Law]

Sorry for delay responding to this thread. I don't pay too close of attention to "Nutrition;" I'm a Snickers bar devotee.

What you describe are classic symptoms of congestive heart failure. Reduced heart function produces a buildup of fluid in digestive organs (particularly the liver, I think) and the system shuts down, "rejecting" any food or water you throw at it.

You don't mention your age, and give no clues as to risk factors for heart disease, but consider this as a possible cause.

I suffered the same exact symptoms for a couple years. In my case the source of the problem was obvious. But I had to go see my cardiologist twice to convince him.

The fix, for me, was simple: a prescription for a diuretic to prevent the fluid build up. Night and day difference. After 2 years of not eating anything more substantial than a Clif bar, I went something like 20 days in a row on the trail this past summer/fall without skipping a single meal.

Hopefully, a gulp of the right flavor of Gatorade will fix you up.

Best of luck in 2015.

[HElinTexas C]

I know the thread has been dormant for a few weeks. However, I noted you are a Floridian and have problems while in the mountains. One factor you might consider is altitude sickness. You mention you workout a lot so it doesn't appear to be a fitness issue. Some people are much more sensitive to altitude than others and you are describing some of the symptoms. Some people experience this even at middling altitude.

I am from tx but lived in fl for awhile. I have had some odd effects from altitude myself. I have found that merely taking it easy for 24-48 hours when I first begin a mountain trip….like really easy….and drinking lots of fluids…greatly reduces or eliminates the problems

[chris smead]

I've had barfy feelings as well, specifically at altitude. I'm kind of a pansy, and if I go from sea level to 11k ft in a day….i feel barfy and lethargic.
Diamox, Advil, and a dual action inhaler seem to make a big difference.

As for non-altitude related barfy-ness….I bring these little ginger chews they sell at the grocery store. Seems to help a little. Also is a nice little treat out there and adds a tiny bit of calories.

[Bob Gross]

Ginger is supposed to be a very low-level anti-nausea food. Some people carry ginger snap cookies in their car, just in case some rider gets motion sickness. Hey, it can't hurt.

It seems like everybody adapts to altitude at a different rate. Some people can go up fast, adapt completely, and never be phased by the altitude. Others aren't quite so lucky. Just to be on the safe side, I like to stick to bland food that won't disagree with me. I do that for at least a day or two before I get to high elevation.

For my first trip to Nepal (18,000 feet), I had never even heard of Diamox. Other trekkers in the group were taking diuretics, but I didn't need it apparently. Before my second trip to Nepal, I was familiar with the literature on Diamox. Although I did not think that I really needed it, I asked my physician for a prescription for it. The physician was amazed. He could not understand why a healthy adult would want a diuretic drug like that. I persisted, and he looked it up and saw that Diamox had a pretty good track record for helping trekkers avoid HAPE or HACE. At the time, they didn't really understand exactly why it was effective. Later, the understanding got much better. It is not recommended for a few people, and it is highly recommended for other groups. Read up on it and then check with your physician.

Personally, I would not use the stuff on a routine basis for backpacking at 10,000 feet. If I was going up to 18,000 or higher, I would at least carry it with me. The only time that I actually consumed it was when we were going to nearly 23,000 feet. That was mostly since there was almost zero chance of rescue when you get that high.

One guy I know will get sick from altitude every time he goes to 11,000 feet or higher, so he uses Diamox routinely.

–B.G.–

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