Intestinal Distress While Running - Warning - Gross

[uk elephant]

In my experience the first batch doesn't really do much. Then about an hour after the second batch, things really start to move. Then if I drink enough water, it really cleans things out. It never comes out totally clear, but usually works pretty good anyway. Try not to worry and try to get a bit of rest when you can! All this stress and emptying is exhausting!

[ClockworkOrange]

Still thinking of you, sending you a real big moth over from England.



I expect the most difficult thing is doing what you are told.........

Sally

[michelem]

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.

[mimitabby]

thanks for sharing all of this with us. And I wish you a speedy recovery

[KSH]

Thanks SO MUCH for having the courage to post this thread and to talk about the problems you have been having.

I have had some GI issues that have been going on since April 22nd (I remember the day as it started after completing a tri that day!).

My problems come and go, but sometimes my stool is bloody. It's not consistent though. There are some days though when I have 7-9 bowel movements... and trust me, they aren't small! He said this could be a problem as that means my body isn't digesting any nutrients.

I went to the Dr. yesterday and he is talking antibiotics and then possibly a colonoscopy (? spelling). Which I want to avoid if I can.

I have copied what you posted above and I will be taking it to my Dr. He doesn't see a lot of athletes, so it might be useful. He even mentioned that he wanted to rule out Kron's (? spelling) disease, etc. He suspects it is a bateria problem in my intestines causing all my issues (aka: bowel movements and sometimes bloody stool).

So, thanks for posting this. I've been a bit embarrased by my problem and haven't really talked to too many people about it. Ya know? It's nice to know that I'm not alone.

[ginny]

ah ha! Kindred spirits! I also have gi issues and am a distance runner - go running 4+ hrs at altitude on the w/e. I have had the dreaded upper and lower gi scope... not fun at all! They didn't really find anything with me... I think it's stress induced (graduate school was not kind to me). Good to know that my running could also be a culprit. I'll keep that in mind the next flare up I get

[michelem]

Well, after-effects of the prep and scope were really awful - water retention up the wazoo (appeared as though I had elephant ankles!) and abdominal bloating. Solid food was just not making down past the upper belly area. UGH. No running yet, but I did go cycling yesterday. Couldn't eat much and even drinking was difficult 'cause it just felt as if nothing was moving down. But, within an hour of getting home today (was out of town overnight) I pooped 3 times - solid, no blood. What a relief! Then I was HUNGRY and ate a lot throughout the rest of the day. Next challenge will be going for a run and seeing what that does to me. I'll probably give it another week and go in the morning next weekend before it gets too hot . . .

Best of luck to the rest of you who have experienced similar problems. It's no fun and it's embarrassing to share, but it's nice to know I'm not alone.

[Grog]

Thanks Michelem for posting your post-experience details. I fortunately do not have problems right now but am scheduled to start coloscopies in my mid-thirties, every year, thanks to a family history packed with colorectal cancer. I'm interested to know what to expect not so much for the tests themselves as for the post-test consequences...

Thanks!!

[LBTC]

Yes, thank you, Michele

I apologize for not being specific when I posted earlier about the after effects I experienced. It's pretty much because I can't really recall!! Luckily for me, these experiences filter out of my consciousness pretty quickly, but that doesn't help others!

I am glad that you are returning to normal and hope that your next running experience is smooth and happy!

Hugs and butterflies,
~T~

[LBTC]

Hi, Michele, KSH and Ginny (and anyone else following this thread).

I remember something my massage therapist told me, that might be relevant to the discussion.

The illeo muscle (yes, I very likely spelled that wrong), otherwise known as the hip flexor, crosses over the front of the hip bones at the bottom end, and at the top end connects to the psoas muscle, which, at its other end, is attached to the back of the abdominal cavity.

In order for the muscle group to go from the back of the area to the front of the area, the muscles wind between the folds of the intestines, and are fascially attached to them. In a fully healthy individual, actively using the ilieopsoas is, I'm sure, normal and without any adverse effects (I'm actually wondering if it even contributes to better function of the intestines by stimulating them); but, if there is a difficulty, like inflammation or the like, with either the muscles or the organs, aggravating one is likely to aggravate the other.

My theory here is that there is already a weakness in the intestines for some reason, which could be, as previously noted, a hydration problem. The activity of running works the ilieopsoas a lot, stimulating and further aggravating the intestines, causing the intestinal distress. I know from my own experience that cycling does not have as detrimental an effect as walking, even, so it is not surprising to me that running would be even worse. This may be because the range of motion used in cycling is much smaller than in running.

Well, anyway, I'm no medical pro or anything, just someone trying to work out the mysteries of my own malfunctioning body, coming up with a theory that might work for you. What would this do to change your protocol? My guess is, as with anything, look for the root cause (poor hydration??), and do what you can to treat that; but also stretch and massage to gain more relaxation and better range of motion in the hip flexors.

Even if I'm wrong, it's not likely to cause you any worse difficulty!

I hope you're feeling well by now, Michele!

Hugs and butterflies,
~T~

[ClockworkOrange]

..........Best of luck to the rest of you who have experienced similar problems. It's no fun and it's embarrassing to share, but it's nice to know I'm not alone.

Hi Michele

So very pleased things are sorting themselves out.

When we sent the PM's a while ago, did not realise it was you, and there you were, asking how I was.

Just continue to take it a little bit easy..............yeah, as if!

Sally

[michelem]

LBTC, I don't know how I missed your reply - so sorry! I do yoga, but will try to be more mindful about stretching the ileopsoas and see if that helps.

Sally, Yup, it's me.

Had another bout of diarrhea last week, but I think it was related to my period - no blood in the stool this time. So, I only ran one day last week and laid off after the diarrhea started (had my last bout on Saturday). I've got a 10-miler planned for tomorrow evening - wish me luck!

[ClockworkOrange]

I've got a 10-miler planned for tomorrow evening - wish me luck!

Hi Michele

Loads of luck coming transatlantic, including a lucky moth!

Sally