HYROX incident: Why runners can lose bowel control during intense races

Endurance athletes train for every challenge, but this is one they rarely talk about

A 1-2 hour HYROX race pushes athletes through extensive endurance challenges, including running and functional exercises at high intensity, such that for some athletes, this can also trigger an urgent need to use the toilet, loose stools (commonly called runner’s diarrhoea), or, in more severe cases, accidental bowel leakage, or faecal incontinence.

Dr Shilpa Gupta, consultant, internal medicine, KIMS Hospitals Thane, told indianexpress.com that “at maximal or prolonged effort”, the body essentially changes its priorities. “Heart rate and blood flow are directed towards muscles and the cardiovascular system, while digestion becomes less important temporarily. Add heat, dehydration, physical stress and hours of continuous movement, and the gastrointestinal tract can become increasingly sensitive. This may result in cramping, nausea, diarrhoea or an urgent need to use the toilet. It is therefore not simply a matter of an athlete having a ‘weak stomach’,” said Dr Gupta.

A recent case in point was Australian athlete Joanna Wietrzyk, who suffered sudden faecal incontinence during the HYROX Beijing event in China on September 12. She continued her attempt to win the women’s HYROX Pro event in 1:01:23. However, the incident drew sharp criticism as the video footage showed fecal matter soiling Wietrzyk’s clothing and legs, as well as contaminating some of the equipment.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

As a result, social media sparked hygiene and safety debates, as well as questions about why the global indoor fitness race organisation didn’t intervene despite rules like “no spitting or clearing your nose/nostrils”. “Go hard or go home, they say… A win is a win,” the winning athlete wrote in an Instagram Stories post which showed her receiving treatment at a hospital, which was later deleted.

In a personal statement on Instagram, the athlete “apologised” to the people of China, and her fellow competitors while stating that at the start of the race, she didn’t feel any health issues. “Personal statement: I want to offer my sincere apology to the people of China, my fellow competitors, the spectators and the HYROX organizers for what happened during the race in Beijing. I felt completely fit and healthy at the start of the race, with no reason to expect any illness. Looking back, I regret the decision to not have stepped off the track. I recognize that I should have made a different choice. I take responsibility for my decision to continue and am deeply sorry for the discomfort and disruption it caused,” she said.

Acknowledging that there is more to life than racing, Wietrzyk addressed the criticism and withdrew the race points. “I know my actions had an impact beyond myself, and I am genuinely sorry to everyone who was affected. I am learning from this experience and will carry those lessons with me, including remembering that there is more to life than racing and knowing when it is right to step away. On reflection, I have decided to retroactively withdraw from the race and forfeit the points I earned. Thank you to those standing by me, both as an athlete and as a person, during this time, and to everyone who has reached out with kindness and support. It means more to me than I can properly express right now. I will be taking some time to recover, reflect and look after myself and my family away from the noise.”

The indoor fitness race, combining eight 1-kilometre runs, each followed by strength training stations including sledge pulls, rowing, and burpees, has grown rapidly from a niche fitness challenge into a global phenomenon since its 2017 founding.

Now, under HYROX’s new rules, a race director may withdraw an athlete if their “blood, vomit, urine, or faeces pose a welfare or contamination risk to the racer or to other racers”.

While the rules have been tweaked after the incident, let’s understand runner’s diarrhoea and how common it is.

Dr Shankar Zanwar, senior consultant gastroenterologist, Gleneagles Hospital, Mumbai, said runner’s diarrhoea is a “common gastrointestinal problem” that can occur during or soon after intense exercise, particularly activities involving prolonged running, repeated high-intensity movements, or endurance training.

Faecal incontinence should not simply be dismissed as part of exercise. “A one-off episode may occur because of acute diarrhoea and extreme exertion, but repeated leakage needs evaluation. It can sometimes point to problems such as reduced bowel control, pelvic-floor weakness, irritable bowel syndrome or another gastrointestinal condition,” asserted Dr Zanwar.

Gulnaaz Shaikh, clinical nutritionist, Healthyz, said race-day nutrition can make a significant difference to gastrointestinal comfort. “Large meals close to exercise, excessive fibre, very fatty foods, unfamiliar foods and high amounts of caffeine may trigger urgency in susceptible athletes. Some sports gels and carbohydrate products can also cause digestive discomfort when consumed in excess or without enough fluid. The key is not to experiment on race day. Athletes should test their pre-event meal and hydration strategy during training,” said Shaikh.

Concurring, Dr Sujit Nair, consultant, medical gastroenterology, hepatology and endoscopy, KIMS Hospitals Thane, said that certain sports drinks, gels and products containing high amounts of sugars or artificial sweeteners may cause bloating, cramps or loose stools in sensitive individuals. “Identifying personal triggers and avoiding foods or drinks that consistently cause symptoms can help,” Dr Nair emphasised.

The aim is to arrive fuelled without overloading the digestive system. Shaikh noted that a familiar, easily digestible meal with appropriate carbohydrates is generally preferable to a heavy meal. “Fibre and very fatty foods may need to be moderated in the hours immediately before a race, depending on individual tolerance. Hydration should begin before the event rather than relying on large amounts of fluid at once. Most importantly, nutrition needs to be personalised. What works for one runner may trigger symptoms in another,” said Shaikh.

According to Dr Zanwar, athletes can reduce the risk by staying adequately hydrated, avoiding unfamiliar or heavy meals before competition, identifying foods that trigger symptoms and allowing enough time for digestion before intense exercise. “If diarrhoea, urgency, or faecal incontinence keeps recurring, is severe, or is accompanied by blood in the stool, significant abdominal pain, fever, weight loss, or persistent changes in bowel habits, a gastroenterologist should assess the underlying cause rather than treating it as a normal consequence of training,” said Dr Zanwar.

Recall that following the incident, organisers apologised to those affected both “directly or indirectly”.

Former field hockey Olympic champion and German co-founder of HYROX, Moritz Fuerste, wrote in a social media statement, “I need to address all of you concerning the recent events in China. I apologise to all that were directly or indirectly affected, as well as to everyone who felt like we did not handle the situation as we should have. HYROX made a mistake by not reacting immediately during the race. In the end, it is my job to foresee these potential incidents — I did not.”

He continued, “Of course, we started improving event processes, plus making rulebook changes immediately. As of this moment, there are new rules and procedures in place to prevent situations like this from happening again. We learn and try to get better every day”.

Viddit Haria, 26, Gurgaon, a sales professional and marathon runner currently preparing for HYROX-style training, told indianexpress.com that running is unpredictable, especially when you push your body to its limits. “An incident like an athlete losing bowel control during a race may sound embarrassing, but it is actually something endurance athletes can experience. I have not participated in a HYROX event yet, but the preparation involves building both endurance and strength. My focus is on gradually improving performance while understanding how my body responds to food, hydration and intense exercise,” he expressed.

Viddit, who runs 10K races and longer-distance events with a personal best of 21.1 km at the Mumbai Half Marathon, said the “bigger lesson is that endurance sport is about knowing your body, preparing well and accepting that sometimes, despite the preparation, the body can surprise you”.