One study found that roughly 70 per cent of athletes experience at least one severe side stitch in a given year. Another study found that 40 per cent of marathoners get an uncomfortable urge to defecate during hard runs. “It’s fair to say,” Wilson writes, “that most athletes occasionally experience gut problems during training or competition.”
There are several reasons for this, but perhaps the most important is that your muscles demand oxygen-rich blood during exercise, which diverts blood away from the gut. The oxygen-starved digestive organs then struggle to deal with whatever partially digested food remains there.
For that reason, hard exercise is a more potent trigger than easy exercise. Activities with lots of jostling, such as running and horseback riding, increase your risk. Women report more gut problems than men, for reasons that aren’t understood. The bottom line: Most symptoms have more than one contributing factor, which means you’ll need to experiment with several possible countermeasures.
[...]
Is it the lactose that’s messing up your workout? For a few people, yes; for most people, no. Same goes for the gluten, the fructose, the fibre, the too-big or too-small meals, the underdrinking or overdrinking. Only you can figure out what your stomach can tolerate.
But once you figure it out, you can change it. Just like your muscles, your digestive tract adapts to the stresses you put on it. If you carb load, your intestine will develop more transporters to ferry those carbohydrates into your bloodstream more quickly. If you practise drinking on the run, your stomach will adapt to feel less full with a bellyful of liquid.