Ischemic colitis in marathon runners: A case-based review

Duke University, Durham, North Carolina, United States
Journal of Emergency Medicine (Impact Factor: 0.97). 05/2006; 30(3):321-6. DOI: 10.1016/j.jemermed.2005.05.021
Source: PubMed


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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    • "This case report examines ischemic colitis in a young female who developed bloody diarrhea during the 2010 Marine Corps Marathon. Endurance athletes suffer a myriad of gastrointestinal symptoms during competition and training to include bloating , abdominal cramps, diarrhea, fecal incontinence, heart burn, nausea, vomiting, chest pain, urge to defecate, and bloody stools [2] [3] [4]. Gastrointestinal symptoms are reported in 20–50% of endurance athletes, more commonly in females, and more often in runners [5]. "
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    ABSTRACT: A 20-year-old female running the Marine Corps Marathon developed diarrhea at mile 12. After finishing the race she noted that she was covered in bloody stool. A local emergency department suspected ischemic colitis. After discharge, her primary care physician instructed her to discontinue the use of all nonsteroidal anti-inflammatory drugs. Her symptoms resolved and she returned to running without any complications. This paper describes the pathophysiology, diagnostic approach, and management options.
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    ABSTRACT: We present a four-year, cross-sectional epidemiologic description of injuries and illnesses among Baltimore Marathon participants and the evaluation, treatment, and disposition of those conditions by an on-site event medical team led by physicians and staff from an urban, academic emergency department. We analyzed data from injuries encountered during the marathon. Subjects presenting to a medical aid station along the course route or at the finish line were defined as "injured or ill" and were prospectively divided into two groups: 1) a brief-encounter group and 2) an extended-encounter group. Data collected included gender, presenting complaint(s), assessment, treatment(s), and disposition. Three percent (N=1,144) of approximately 33,700 total participants over four years presented to medical aid stations during the Baltimore Marathon between 2002 and 2005. Most participants (66%) did not require a full clinical evaluation. Common complaints encountered were dehydration (32%), musculoskeletal injuries (25%), and cutaneous wounds (20%). Transport to the hospital was required for 4% of all injured participants, and 61% returned to the race. Most injuries/illnesses encountered at the Baltimore Marathon in 2002-2005 were minor, although some were serious enough to require transport to a hospital. The year with the highest average race-day temperature had the highest observed injury rates and the highest number of hospital transports. These results help to improve understanding of the types, severity, and distribution of injuries commonly sustained by marathon participants and may guide decisions regarding the appropriate distribution of emergency medical resources at such events.
    No preview · Article · Jan 2008 · Prehospital Emergency Care
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