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Cited by 103Abdominal vascular conditions and treatmentsGastrointestinal Bleeding Diagnosis and TreatmentExercise and Physiological Responses

Acute ischaemic colitis in a female long distance runner.

Open access
Heer, M, Repond, F, Hany, A, Sulser, H, Kehl, O, Jäger, K·1987·Gut
DOI 10.1136/gut.28.7.896PMC PMC1433062
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Abstract

A 34 year old female long distance runner is reported with bloody diarrhoea. Colonoscopy revealed patchy haemorrhagic mucosal lesions throughout the colon. The most extensive lesions were found in the sigmoid colon. Histologic examination disclosed mucosal haemorrhage, dilated capillaries, patchy fibrosis and superficial erosions. Additional findings in this patient were haemorrhagic gastritis, microscopic haematuria and rhabdomyolysis. The only medication taken by the patient was oral contraceptives. We conclude that ischaemic colitis is one of the possible mechanisms leading to gastrointestinal blood loss in competitive runners.

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Crossref · 10.1136/gut.28.7.896

Cites

29 of 29 references verified0 citation errors · 0 not checkable

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  • Marathon runners and long-distance triathletes occasionally have blood loss in the feces in the hours following a marathon.

    “For example, marathon runners and long-distance triathletes occasionally have blood loss in the feces in the hours following a marathon.”

    From Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations (2014) · cites this paper as [14]

    The Discussion says occult bleeding occurs in marathon runners, and the case report describes bloody stools within an hour of a 15 km race. It does not address triathletes or establish that the bleeding occurs in the hours following a completed marathon. Page numbers are unavailable in our copy. (LLM, conf=0.87)

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  • Proximal, distal, or pancolitis, and even small bowel infarctions have been reported in athletes and in some cases have required surgery.

    “Proximal, distal, or pancolitis, and even small bowel, infarctions have been reported in athletes and in some cases have required surgery [14, 16].”

    From Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations (2014) · cites this paper as [14]

    The Discussion reports acute ischaemic lesions throughout the colon in a long-distance runner, supporting the pancolitis portion of the claim. It does not report small-bowel infarction in an athlete or surgery; its mention of small-bowel ischaemia concerns young women taking oral contraceptives. Page numbers are not specified for these Discussion passages. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Blood loss as a result of ischemic colitis is not uncommon in athletes, and can be profound in extreme cases.

    “Blood loss as a result of ischemic colitis is not uncommon in athletes, and can be profound in extreme cases.”

    From Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations (2014) · cites this paper as [14]

    The Discussion reports that long-distance running occasionally induces ischaemic colitis with gastrointestinal blood loss. It says bloody diarrhoea is rare, not that blood loss specifically caused by ischaemic colitis is common. The reported extensive mucosal haemorrhage does not establish that blood loss can be profound. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Among the reported deleterious manifestations of strenuous exercise are mucosal erosions and ischemic colitis, both observed after long-distance running.

    “Among the reported deleterious manifestations of strenuous exercise are mucosal erosions and ischemic colitis, both observed after long-distance running [12–14].”

    From Gastrointestinal Complaints During Exercise: Prevalence, Etiology, and Nutritional Recommendations (2014) · cites this paper as [14]

  • GI epithelial damage may be directly associated with oxidative stress from GI ischemia.

    “GI epithelial damage may be directly associated with oxidative stress from GI ischemia (particularly hydrogen peroxide), and in extreme cases may lead to ischemic colitis or infarct tissue [66].”

    From An Exploratory Investigation of Endotoxin Levels in Novice Long Distance Triathletes, and the Effects of a Multi-Strain Probiotic/Prebiotic, Antioxidant Intervention (2016) · cites this paper as [66]

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Cites

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Research works printed but not linked: 4

  1. [5]Volpicelli N. Effects of sports on the gastrointestinal tract and liver. In: Appenzeller 0, Atkinson R, eds. Sports medicine: fitness, training, injuries. Baltimore- Munich: Urban & Schwarzenberg, 1983: 91-8. on July 14, 2023 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gut.28.7.896 on 1 July 1987. Downloaded from
  2. [7]Schaub N, Spichtin HP, Stalder GA. Ischamische Kolitis als Ursache einer Darmblutung bei Marathonlauf? Schweiz Med Wochensch 1985; 115: 454-7.
  3. [9]Kehl 0, Jager KA, Munch R, et al. Mesenteriale Ischamie als Ursache der "Jogging-Anamie"? Schweiz Med Wochensch 1986; 116: 974-6.
  4. [19]Whitehead R. The pathology of intestinal ischaemia. Clin Gastroenterol 1972; 1: 613-37.

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Authors
Heer, M., Repond, F., Hany, A., Sulser, H., Kehl, O., & Jäger, K.
Affiliations
Kantonsspital Winterthur (CH)
ORCID
Hany, A
Venue
Gut
Publisher
BMJ
Published
1987-07
Volume
28
Issue
7
Pages
896-899
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
DOI
10.1136/gut.28.7.896
PMC
PMC1433062
OpenAlex
W2164133033
Cited by
103
References
29
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2020: 1 · 2019: 2 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 4 · 2013: 2 · 2012: 7
FWCI
2.34
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
long-distance running, hemorrhagic colitis, bloody diarrhea, microscopic hematuria, rhabdomyolysis, gastrointestinal blood loss, oral contraceptives, competitive runners, sigmoid colon
MeSH terms
Acute Disease, Adult, Colitis, Colon, Diarrhea, Female, Gastrointestinal Hemorrhage, Humans, Ischemia, Running

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