Well, the test is over and I am home recovering. Got home around 11am and slept 'til 5pm. I still feel energy-less. Bleh.

Had to have an enema and then get "sucked out" before the procedure because the phospho-soda didn't get me "clear." Yuck.

So, now for the results. No polyps, tumors, or ulcers, so that is good. The doc's preliminary thoughts are that it was one of two things:

(a) intestinal infection
(b) ischemic colitis

If (a), then antibiotics will resolve it and I shouldn't have anymore problems. If (b), I will likely know on my next longish run.

Here is some info on GI bleeding and running:

GI Symptoms
Exercise, especially running, can also be a stress test for the colon. Indeed, GI problems are common among athletes and active people (7,8). Exercise-related problems include upper-GI symptoms such as nausea, bloating, and acid reflux as well as lower-GI symptoms such as cramping, diarrhea, and even rectal bleeding.

GI bleeding, which occurs notably in distance runners or triathletes, stems from the upper or lower GI tract and ranges from occult and trivial to overt and grave (9). Ischemic colitis, often heralded by lower abdominal cramping and bloody diarrhea, is perhaps the most ominous GI complication of endurance racing. This can be considered an "athletic" cause of colitis because it likely results from dehydration and blood diversion from the gut to working muscles. At its worst, ischemic colitis can require subtotal colectomy, as in a female distance runner (10) and in two elite triathletes (one female, one male) in the Ironman Triathlon Championship.

Bloody diarrhea, of course, can also be from nonathletic causes, as in a female swimmer and male baseball pitcher who had bloody diarrhea from ulcerative colitis (8). Vigorous exercise can also be a "colonic stress test" that unveils infectious diarrhea. Examples are an 8-year-old boy who developed diarrhea only when playing basketball and was found to have giardiasis (11), and a 48-year-old man who for 4 months had diarrhea mainly during distance running and eventually was found to have intestinal amebiasis (12).

TAKE-HOME MESSAGE. By stressing the GI tract, exercise—especially distance running—can unmask diverse conditions. Usually, these are just annoying manifestations of disrupted physiology (ie, nausea, bloating, belching). Occasionally, however, cramping and diarrhea can herald serious colitis, be it infectious, inflammatory, or ischemic.

7. Green GA: Exercise-induced gastrointestinal symptoms: a case-oriented approach. Phys Sportsmed 1993;21(10):60-70

8. Putukian M: Don't miss gastrointestinal disorders in athletes. Phys Sportsmed 1997;25(11):80-94

9. Eichner ER: Gastrointestinal bleeding in athletes. Phys Sportsmed 1989;17(5):128-140

10. Beaumont AC, Teare JP: Subtotal colectomy following marathon running in a female patient. J R Soc Med 1991;84(7):439-440

11. Tudor RB: Giardiasis and exercise-induced diarrhea (letter). N Engl J Med 1978;299(26):1471-1472

12. Swain RA: Exercise-induced diarrhea: when to wonder. Med Sci Sports Exerc 1994;26(5):523-526



I can see how the ischemic colitis makes sense as that evening was the first that I ran in such a warm temperature (90 degrees or so). Not so warm if one is acclimated, but prior to that I had been running in 80 or less degree weather (I usually go about 90 minutes prior to sunset). Also, I know I didn't drink enough fluids that day. So, next time I go out for a run I will 1) make sure I am well-hydrated, 2) if it is warm, go for shorter duration, and 3) at the first sign of cramping, slow down and/or walk. In hindsight, it wasn't the smartest thing to speed up and keep going when the cramping started - all I was thinking was that I wanted to complete the entire run and if I ran faster/harder I'd be able to get home to the bathroom sooner! I should have turned around and gone back home right then and there.

Thanks again to everyone for your support and encouragement. And let this be a lesson to you that adequate hydration is really important for runners! For some reason (from what I've read, it's probably the pounding), while common for runners, ischemic colitis is pretty rare for cyclists.