Ischemic colitis in marathon runners: A case-based review
ABSTRACT In the United States over 450,000 participants finished a marathon in 2002. Some of them will present to an Emergency Department (ED) with a variety of gastrointestinal complaints. The diagnosis of ischemic collitis should be considered in patients who present with bloody diarrhea. We describe three patients who presented to our ED with abdominal pain and bloody diarrhea after a marathon. Gastrointestinal complaints with emphasis on mesenterlic lischemia and ischemic colitis are discussed. (c) 2006 Elsevier Inc.
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ABSTRACT: Sports medicine clinicians may encounter a wide variety of activity-related gastrointestinal (GI) disorders. The advancing ages and burgeoning obesity rates of the US population have generally increased the prevalence of GI conditions among adults. However, conditioned younger athletes with normal body mass indices also may experience disquieting activity-related GI disorders. While often mild and transient, some of these GI conditions may disrupt exercise routines or pose significant health risks to affected individuals. Gastroesophageal reflux occurs frequently during physical activity and should be empirically treated with activity reduction and dietary modifications in conjunction with antisecretory agents. Persistent or worrisome symptoms merit upper endoscopy, a thorough evaluation for non-GI causes and, rarely, surgery. Altered GI motility commonly occurs during vigorous activities that use dynamic or fluctuating body positions. Dietary and exercise modifications are usually enough to resolve these symptoms. Physical activity may also precipitate GI bleeding from upper and/or lower sources. Although mild or occult bleeding is most common, significant bleeding merits a thorough diagnostic evaluation after stabilization and treatment. Adequate hydration and gradual exercise progression may be particularly helpful to prevent the recurrence of bleeding. The judicious use of medications in conjunction with nonsteroidal anti-inflammatory drug avoidance may also be necessary. Fortunately, most activity-related GI disorders are self-limited and can be managed conservatively. After a brief period of modified activity, clinically stable individuals may progress their activity levels as symptoms allow.The Physician and sportsmedicine 04/2009; 37(1):54-63. DOI:10.3810/psm.2009.04.1683 · 1.49 Impact Factor
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ABSTRACT: Sports anemia is a widely observed phenomenon after prolonged running. There are various factors that contribute to sports anemia, including hemodilution, exercise-induced oxidative stress, iron deficiency, gastrointestinal bleeding, hematuria, and hemolysis resulting from foot-strike and/or from compression of contracting muscles on capillaries. Until now, there has been no prior literature that investigated the overall hematological, urinary, and fecal consequences in Asian male ultramarathoners after a 100-km (62.5-mile) ultramarathon event.MethodsA total of 25 male runners were recruited into our study. Blood was drawn 1 week prior to, immediately after, and then 24 hours subsequent to the race. Hematological samples were analyzed for the anemia phenomenon. Additionally, urinary and fecal samples were collected prior to and after the race for detection of occult blood.ResultsThe blood hemoglobin and erythropoietin values of the recruited runners showed a statistically significant rise in the immediate post-race values and a rapid drop in values at 24 hours post-race. Blood concentrations of red blood cells and hematocrit were significantly lower at 24 hours post-race compared with pre-race. The white blood cell count, interleukin-6, tumor necrosis factor-alpha, high-sensitivity C-reactive protein, and ferritin all showed significant increases both immediately after and 24 hours post-race compared with pre-race hematological values. There were immediate decreases of both haptoglobin and iron, as well as an increase of total iron-binding capacity levels in post-race blood tests. For both urinary and fecal samples, there was a statistically significant difference between the pre- and post-race results in occult blood.Conclusion Running a 100-km ultramarathon will induce substantial sports anemia, and oxidative stress response, hemolysis, hematuria, and gastrointestinal bleeding are typical factors that contribute to its onset.Journal of the Chinese Medical Association 11/2014; 78(2). DOI:10.1016/j.jcma.2014.09.004 · 0.89 Impact Factor
- The American Journal of Gastroenterology 01/2015; 110(1):18-44. DOI:10.1038/ajg.2014.395 · 9.21 Impact Factor