I poo myself every week while running – but I won’t stop

‘College ruined me’, Tiffani says (Picture: Tiffani Koonce) ‘Yo, come get me. There is poo coming down my leg’. It’s a call 20-year-old Tiffani Koonce has made to her boyfriend Cayde de Waal many times over the past year. A student athlete, Tiffani jogs almost every day, and almost once a week, she will experience the runs during one of those runs. ‘It first happened when I was 17 and I was at high school doing cross country. I don’t really remember the moment, just that I told my coach: “something’s happened, I gotta go.”’ Tiffani thought it was a one-off but after starting college a year later, bowel incontinence became a regular occurrence. ‘College ruined me’, she tells Metro from her dorm room in Illinois. Tiffani has phoned Cayde asking to be picked up more than once (Picture: Tiffani Koonce) ‘When I feel it coming, I hold it for as long as I can while I see if there are any nearby toilets, but I just get to a point where I can’t anymore’, Tiffani admits. It’s not diarrhoea that Tiffani experiences, more the inability to control when a movement comes out. In the past three years she has had many mid-run hunts for port-a-loos, has adopted a squat on a roadside more than once, and has even had to walk a mile back to the house in soiled underwear, trying to avoid other people. While Tiffani considers this habit an ‘inconvenience’, she refuses to feel embarrassed. In fact, she’s posted some of her ‘accidents’ on social media. ‘I’m kind of an oversharer’, she admits. This may explain why, the first time Cayde picked her up, she decided to record and post it to TikTok. Ask Metro Use AI to go deeper into the stories you care about – powered by Metro and trusted publications. ‘He turned up with a roll of toilet paper. It was far too late for that and I found it really funny. When I got in the car he was holding his nose and had the windows rolled down.’ That video blew up, and when she posted another to TikTok this summer – this time with Cayde offering a towel – it was the same, with 1.7million views and nearly 2,000 comments. According to Tiffani’s doctor ‘sometimes this just happens to runners’ (Picture: Tiffani Koonce) Among the ‘another reason not to run’ and ‘are you selling the shorts?’ comments, there were people trying to make Tiffani feel embarrassed about it. ‘But it’s not something I can control,’ she explains. They suggested that the athlete tries going to the loo before (she does), or not eating before she runs (‘I need the energy’), but Tiffani has heard it all. ‘I try to explain to the best of my ability that this is just what my body does and they just don’t get it’. According to Tiffani’s doctor ‘sometimes this just happens to runners’ and, after checking Tiffani over, her doctor is not concerned. Neither is Tiffani, especially as she finds this only happens to her during the summer. Tiffani is thankful that she has never had a race interrupted by a ‘movement’ (Picture: Tiffani Koonce) ‘Bowel incontinence is a more common problem than people realise – but anyone experiencing it shouldn’t pass it off as something that just happens without being examined,’ says Lucy Allen, Consultant Digestive & Pelvic Health Physiotherapist. ‘There isn’t one single cause; it’s more typically a combination of physiological, psychological, mechanical and nutritional,’ Allen explains. ‘From a physiological perspective: during intense exercise, blood flow is directed away from the gut and stress hormones can impact the digestive system, speeding it up. ‘In Tiffani’s case, heat could exacerbate symptoms if it’s a particularly hot environment due to redirection of blood flow and this impact on gut function.’ Following Joanna Wietrzyk’s Hyrox win, where the athlete continued to compete after soiling herself, bowel incontinence during sport has been discussed more openly. Joanna Wietrzyk faced significant backlash after continuing to compete (Picture: VCG/VCG via Getty Images) While Allen wouldn’t be able to give a verdict on Tiffani or Joanna’s cases without meeting them, she says that there are various reasons why this could happen. ‘Mechanically, if an athlete has an underlying muscle dysfunction within the pelvic floor or anal sphincters – either weakness, or inability to fully relax – it would impact their ability to control stool when exercising. If the stool is looser, this places a greater strain on the mechanics. ‘Nutritionally if an athlete hasn’t eaten the best foods prior to competing then it can cause gastrointestinal upset.’ This latter cause was posited by Paula Radcliffe, who apologised to the nation after relieving herself on the side of the London Marathon in 2005 and later said it was likely due to too much gluten-free pasta and grilled salmon the night before. Another cause is that of the physical jostling of the organs brought about by running; and that this movement, combined with the reduced blood flow described by Allen, can cause food to move through the bowel faster than normal. According to Allen, bowel incontinence impacts around 5-10% of people in the UK alone (Picture: Tiffani Koonce) Tiffani is thankful that she has never had a race interrupted by a ‘movement’ but says that, unless she was metres away from the finish line and going to get a personal best, she wouldn’t continue. But she knows how common this issue is among athletes. While none of her peers have experienced it, to her knowledge, the comments of her TikTok were flooded with people who had had similar struggles. According to Allen, bowel incontinence impacts around 5-10% of people in the UK alone but says it is a poorly studied area in athletes. She emphasises that ‘we can’t directly compare Paula Radcliffe with Joanna Wietrzyk, for example, as they were participating in very different activities, in different environments.’ Still, she acknowledges that ‘bowel incontinence when running is more common in endurance athletes’ and for women, factors like childbirth and hormones will play a role. For Tiffani, the main struggle isn’t actually soiling herself: It’s the clean up and what comes next. ‘Where I can, I try to salvage my shorts, hosing them down before putting them in the machine. Then I have to wash myself. Then I have to go back out to finish my run’. The only solution she has found to her problem is to run with her phone so she can call for help (Picture: Tiffani Koonce) As a college athlete, Tiffani has a strict training schedule, meaning she can’t just be done because her body wants her to be. ‘I have to run 55 miles every week, poo or no poo.’ ‘On Mondays, I run. Tuesdays I do a running workout, followed by weights. Wednesdays involve a run in the morning and the afternoon. I recover on Thursday because Friday means a hard workout with weights. Saturday is a shorter run before 10-11 miles on Sunday.’ The only solution she has found to her problem is to run with her phone so she can call for help. The first time it happened, her then-boyfriend’s mum picked her up; nowadays, it’s Cayde. Getting help ‘No bowel incontinence is normal,’ says Allen. She recommends getting checked over if you have any of the below symptoms, so doctors can rule out any underlying bowel or muscular issues. Regular incontinence Bleeding either on the stool, in the toilet or on wiping Change in bowel habit for more than 3 weeks Abdominal pain Persistent bloating Feeling of incomplete bowel emptying or pressure in the bottom Unexplained weight loss Any neurological symptoms ‘Everyone’s always been nice when it happens’, Tiffani says. She has learnt to be upfront about it. On a recent trip to South Africa to meet Cayde’s family for the first time, she went out for a training run and had to waddle back after experiencing the familiar sensation. ‘They knew that this sometimes happens to me and so waited patiently for me to get cleaned up before we headed out for our planned sunset photoshoot’. While Tiffani doesn’t plan to continue her running career after university, it’s not because of her bowels. In fact, she sees herself becoming a ‘hobby jogger’, accompanying Cayde on his daily runs. For now, Tiffani is welcoming the onset of winter, a period where her accidental poos calm down. 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