Son Goes Pale Mid-Race, Vomits After Every 1600/3200 – Anyone Been Through This?

You might want to update your knowledge on that. But then again, you might not care.

I think it's possible that your son has a terrible case of Pucci-itis. Signs of this disease are inability to compete, inability to withstand pain and discomfort of any type for any length of time.

Cure: joining the drama club.

I agree - ask for endoscopy. Also you can about antiemetic like Zofran to see if it makes a difference.

The vasovagal response is possible but in my opinion unlikely. The reason is that HR would likely be elevated by the first 400 and should continue to stay elevated. Vagal stimulus could happen in the recovery phase, but I’m not certain he would have a vagal response (decreased heart rate), look pale and then bomit when done. Vasovagal responses I’m sure can have nausea associated with it, but more typically syncope, which has not been described.

I immediately thought of splancnic and mesenteric blood flow and the physiological effects described below. Would recommend cardiac treadmill stress test and upper endoscopy.

https://journals.physiology.org/doi/full/10.1152/ajpgi.00066.2012

So can he replicate the vomiting in practice? During a high lactate session such as late track season 800m and 1500m race pace sessions?

If not, don’t underestimate the ability that being nervous can cause GI distress. Racing can bring out the worst of nervousness in athletes.

Quite a number of sports scientists seem to think it's a real thing. e.g.

pubmed.ncbi.nlm.nih.gov

Lactic acidosis: implications for human exercise performance - PubMed

During high-intensity exercise a lactic-acidosis occurs with raised myoplasmic and plasma concentrations of lactate- and protons ([lactate-], [H+] or pH). We critically evaluate whether this causes/contributes to fatigue duri...

Open link

(published this year)

Why do you think it's not a real thing? (genuine question - just want to understand)

Very very late to this. But may I ask what an “episode” would look like for your 2 athletes?

Vasovagal is a reasonable guess as is GERD related however based on what detail you offered in your report, and the fact that an underlying mechanism is required, my sense is he is actually struggling due to the work of breathing… (which is both exercise time and intensity related) simply put he is failing to blow off CO2 and in the process triggering the nausea, and lightheaded through increased abdominal pressure.

My secondary suggestion if respiratory work and training fixes do not resolve this, is to check him for enteric neuropathy

I puked a lot my first few years of track, running mostly the 400. Looking back, it seemed relatively common among us young athletes. I finally stopped puking after races, and only puked a few times after super hard practices or when it was super hot.

What kind of shape is his core in? Does he do core work like sit ups? He could be overloading his system in races if he’s not strong enough. Also, agree with those suggesting distancing eating from race time.

I developed something similar to this about 4 or 5 years into competitive running, and would experience it running anything between 400 and 3000, but most often 800-1600. Even after finishing a fast final rep on a speed workout could trigger it. I would feel nauseous after finishing, and it could extend for 30-60 mins after racing, but as soon as I puked it immediately went away. So as soon as I finished I would make myself puke asap just to get it over with. Didn’t affect my performance at all so I just dealt with it. Would not surprise me if it had something to do with my body dealing with lactic, but that’s just conjecture. Every body is different and sometimes finding ways to deal with a problem is more realistic than “solving” it.

Same here. It never bothered me and other guys in the team did the same. We made ourselves into a little club called the "Barfing Brothers." This kept on into my freshman year of college then it mostly went away but I've still done it a handful of times even as a masters runner. I just took it as something that meant I had pushed really hard.