Kidney, Bowel, Medicines and Ultra
8th IAU 24H World Championship17th IAU 24H European Championship
Dr Arthur BruléFédération Française d'AthlétismeMedical referent 24h and 100km
May 11th 2010
Introduction
● Study by French Triathlon Federation
● Automedication :● 15% olympic distance
(effort during 2 hours)● 44,7% Ironman (effort
during 8 hours or more)
Toxic waste
After :●Extraction of the energy of the food ●Use during activities●Maintenance of the body
The waste becomes toxic if they are not eliminated
3 possibilities of elimination
● Renal ● Intestinal● Cutaneous
Kidneys
● 150 grams each● 1 million units of
filtration ● Eliminate the waste of
the blood● Adapt salts and water
according to needs
Cutaneous elimination
● The sweating is proportional in the temperature and in the activity
● The physiological maximum is 2 liters per hour and 15 liters by 24 hours
Before the competition
● Increase of the number of urinary micturition by excitement which decreases the threshold of sensibility of the bladder
● A correct hydratation must be obtained the previous days and not only the morning of the event
During the competition (kidneys)
● The quantity of urines decreases and becomes intermittent
● The renal blood flow is reduced by 70% especially if the temperature is raised
● The filtration of the kidneys decrease especially if there is a deshydratation
● The blood is directed to muscles
During the competition (skin)
● Fatigue of sweat glands causes a decrease in flow
● concentration of minerals decreases sweating is important
Medicines and running
● During a marathon : 24% of the runners have blood in their saddle
● Among them, 80% consumed anti-inflammatory drugs (NSAID)
● NSAID thus multiplies the risk by 40
Example of elimination in the rest
● Ketoprofene (Ketum*)● Half is eliminated in 6
hours and the rest during 5 days !
● Aspirine is an NSAID
We will see just few examples of side effets of medicines during the running
Aspirin
● Decrease of the efficiency of blood platelets
● Negative impact on the muscle in the effort
● Risk of acute renal insufficency
● Decrease of the blood flow of the stomach by vasoconstriction of small arteries
● Increase of the digestive bleedings
● Gastric pains
Paracetamol – Diosmectite
● Hepatitis metabolisation then renal elimination
● Acute hepatitis possible
● Less risk than NSAID
● Smecta* in France
● Beneficial effect demonstrated on runner's trot
● Not absorbed by the bowel
● Modification of the intestinal wall and the absorption of elements of the food
● Can cause vomits
Herbal Medicine
● For example : Harpagophytum
● Indications in the pains (acute lumbago, degenerative osteoarthritis), decrease the intestinal discomfort, the diarrhea and stimulate the appetite
● Botanic name : Harpagophytum procumbens
● English name : Devil's claw root
● Plant of the desert regions of the southeast of Africa
Herbal Medicine, example with Harpagophytum
● Side effects : forbidden in case of stomach ulcer, can cause some minor intestinal disorders
● Interference with some medicines (i.e. : warfarine)
● Few complete studies
Homoeopathy
● Use of a toxic active principle in an important dilution while waiting for beneficial effects
● Dilution “5CH” : one glass of beer in 1000 Olympic swimming pools
● Well implanted in France, more modest utilisation worldwide
● The principal interest : no side effects , also during ultra running
Conclusion
Be careful and run with your head
