
L’UTMB et les troubles digestifs
Cette semaine, j’étais bénévole sur l’UTMB. L’Ultra Trail du Mont Blanc, c’est LE rendez-vous de la planète ultra-trail où les athlètes se retrouvent pour faire le tour du grand blanc. Tous les meilleurs s’y retrouvent pour un superbe événement à Chamonix. Mêlant efforts extrêmes, convivialité, performance et solidarité la semaine est à la fête. Pour avoir une petite idée, les courses vont de 42km à 170km (avec 10 000mD+ pour corser le tout) à réaliser en moins de 46h30 soit 2 nuits dehors en montagne en courant pour rallier la ligne d’arrivée !!
Ces coureurs professionnels et amateurs ne rejoindront pas tous la ligne d’arrivée. En moyenne seuls les 2/3 y arrivent.
Les causes d’abandons sont nombreuses : blessures, épuisement, douleurs mais une cause fréquente revient toujours : les troubles digestifs !
C’est franchement regrettable. La plupart de ces coureurs ont réalisé des sacrifices énormes auprès de leur famille, sur leur sommeil pendant des mois pour se préparer physiquement. Et ils abandonnent pour cause de troubles digestifs.
Qu’est-ce qu’il se passe concrètement ?
La plupart ont soit la diarrhée, soit sont incapables de s’alimenter au bout d’un certain temps, souvent après une cinquantaine de kilomètres.
Après avoir échangé avec certains d’entre eux, la plupart concède ne pas avoir fait de préparation alimentaire spécifique. Parallèlement ils admettent aussi avoir TRES souvent voire, TOUJOURS des problèmes d’ordre digestif en course.
Ca me parait inconcevable. Il est effectivement indispensable de faire une bonne préparation physique pour envisager courir de telles distances. Cependant il est aussi indispensable de réussir à faire fonctionner son corps tout au long de la course. Et ça, ça dépend de l’énergie qu’on est capable de lui apporter.
Chaque coureur est unique et chaque problématique d’ordre digestive se traite de manière individualisée mais une course ça se prépare, ça se prépare en amont et ça se prépare sur tous les plans.
Comme on sait exactement quelles chaussures on portera, quel matériel on emportera et quelle tenue on enfilera pour des raisons techniques, on doit aussi anticiper son alimentation.
La préparation de l’alimentation se fait en deux temps :
1. Les mois avant la course
C’est souvent cette partie-là qui est délaissée par les coureurs. Leur entrainement nécessite déjà de tels sacrifices que de devoir en plus faire attention à ce qu’ils mangent ne les enchante pas plus que ça. Et pourtant c’est là que se joue la capacité à finir la course pour nombre d’entre eux.
Les efforts longs entrainent porosité intestinale et acidité gastrique.
On peut alors travailler sur deux plans en amont :
- Les compléments alimentaires pour renforcer la barrière intestinale (la L-Glutamine est souvent indiquée).
- Le régime alimentaire pour prévenir les risques et éviter d’empirer les symptômes.
2. L’alimentation le jour de la course
Il est de plus en plus fréquent toutefois de voir que les coureurs anticipent bien la préparation de leur alimentation pendant l’effort. Ils savent ce qu’ils vont manger, ils savent ce qu’ils vont boire mais ils ne peuvent pas faire régulièrement des entrainements de plus de 50km. En conséquence, pour eux après c’est souvent l’inconnu.
Aussi, l’effort entraine ce qu’on appelle une ischémie transitoire. C’est le fait de ne pas avoir faim car le système digestif n’est plus irrigué car la priorité va à la contraction des muscles.
C’est une des grandes raisons des troubles. Le schéma classique c’est de ne pas avoir faim pendant la première partie de course, jusqu’à ce que l’estomac soit complètement vide. Puis la faim survient (ou la raison lorsqu’on se rend compte qu’on n’a rien mangé depuis un bon bout de temps) et c’est là que ça se gâte. Lorsque les aliments arrivent (parfois en trop grande quantité) ils arrivent dans un milieu particulièrement acide et sont très mal absorbés (en résumé). C’est alors que ça commence à mal se passer.
Avoir un plan de course est très pratique. Il faut y coupler un plan alimentaire pour avoir bien conscience de ses besoins. Cela se prépare en amont avec un spécialiste.
Petit conseil :
- Pour l’ensemble de la course l’alimentation est souvent bien répartie en moitié liquide, moitié solide
- Quand on choisit de prendre une boisson d’effort, attention à la température extérieure ! En effet, quand il fait chaud on boit plus et quand il fait froid on boit moins. Pour autant il faut respecter le ratio de 50g de glucides / heure max en liquide ! Solution quand il fait chaud : sous-doser sa boisson d’effort et compléter par les gels et compotes.

Comment choisir sa boisson d’effort ?
Elle doit contenir :
- Entre 4 et 8 g de glucides / 100ml de boisson
- Entre 50 et 70 mg de sodium / 100ml de boisson

Naturopathe à Compiègne et en distanciel, je suis spécialisée en diététique et en gestion des troubles du sommeil. Diplômée depuis mai 2021, j’exerce mon activité en partie au chalet de Jaux et en partie en visio. Je suis également détentrice d’une carte professionnelle d’activité de remise en forme me permettant d’accompagner les Compiégnois.e sur une reprise sportive bien encadrée. Cliquer ici pour en savoir plus.
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