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Gastrointestinal bleeding during an ultramarathon

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Digestive symptoms and gastrointestinal bleeding occur in endurance runners and may contribute to runner's anemia. The cause is unknown, but the frequency of fecal blood loss has been reported to be 8–23% of marathon runners (1–7). Races of longer distances have not been investigated. An ultramarathon is a race that is longer than the 26.2 miles of a marathon and commonly involves distances of 30–100 or more miles and can last 24 hr or more. It differs from the marathon in duration, pace, and intrarace diet. The Old Dominion One Hundred Mile Endurance Run is held in the mountains of Virginia each June. It is open only to experienced ultrarunners who have completed a 50-mile race in less than 9 hr. This race offers a unique opportunity to study highly trained individuals undergoing a tremendous stress to not only their cardiovascular and musculoskeletal systems but also to their gastrointestinal system. The purpose of this prospective study is to determine the incidence of Hemoccult positivity occurring in association with an ultramarathon and evaluating, by means of a questionnaire, cofactors contributing to the gastrointestinal bleeding.

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  1. Buckman MT: Gastrointestinal bleeding in long distance runners. Ann Intern Med 101(1): 127–128, 1984

    PubMed  Google Scholar 

  2. Halvorsen FA, Lyng J, Ritland S: Gastrointestinal bleeding in marathon runners. Scand J Gastroenterol 21:493–497, 1986

    PubMed  Google Scholar 

  3. Stewart JG, Ahlquist DA, McGill DB, Ilstrup DM, Schwartz S, Owen RA: Gastrointestinal blood loss and anemia in runners. Ann Intern Med 100(6):843–845, 1984

    PubMed  Google Scholar 

  4. McMahon LF, Ryan MJ, Larson D, Fisher RL: Occult gastrointestinal blood loss in marathon runners. Ann Intern Med 100(6):846–847, 1984

    PubMed  Google Scholar 

  5. McCabe ME, Peura DA, Kadakia SC, Bocek Z, Johnson LF: Gastrointestinal blood loss associated with running a marathon. Dig Dis Sci 31(11): 1229–1232, 1986

    PubMed  Google Scholar 

  6. Robertson JD, Maughan RJ, Davidson RJ: Faecal blood loss in response to exercise. Br Med J 295:303–305, 1987

    Google Scholar 

  7. Porter AM: Do some marathon runners bleed into the gut? Br Med J 287:1427, 1983

    Google Scholar 

  8. Thompson PD, Funk EJ, Carleton RA, Sturnes WQ: Incidence of death during jogging in Rhode Island from 1975 to 1980. JAMA 247:2535–2538, 1982

    PubMed  Google Scholar 

  9. Fogoros RN: “Runners trots,” gastrointestinal disturbances in runners. JAMA 243(17)1743–1744, 1980

    PubMed  Google Scholar 

  10. Papaioannides D, Giotis C, Karagiannis N, Voudouris C: Acute upper gastrointestinal hemorrhage in long-distance runners. Ann Intern Med 101(5):719, 1984

    Google Scholar 

  11. Moses FM, Brewer TG, Peura DA: Running associated proximal hemorrhagic colitis. Ann Intern Med 108:385–386, 1988

    PubMed  Google Scholar 

  12. Cooper B, Douglas S, Firth L, Hannigan J, Chadwich V: Errosive gastritis and gastrointestinal bleeding in a female runner. Gastroenterology 92:2019–2023, 1987

    PubMed  Google Scholar 

  13. Porter AM: Non-steroidal anti-inflammatory drugs and ethanol. Br J Sports Med 16:265, 1982

    PubMed  Google Scholar 

  14. Fisher RL, McMahon LF, Ryan MJ, Larson D, Brand M: Gastrointestinal bleeding in competitive runners. Dig Dis Sci 31(11): 1226–1228, 1986

    PubMed  Google Scholar 

  15. Lind RH: Medical results of the NSAIDS in ultramarathon runners. Ultrarunning 1986

  16. Sullivan SN: The effect of running on the gastrointestinal tract. J Clin Gastroenterol 6:461–465, 1984

    PubMed  Google Scholar 

  17. Keeffe EB, Lowe DK, Goss JR, Wayne R: Gastrointestinal symptoms of marathon runners. West J Med 141:481–484, 1984

    PubMed  Google Scholar 

  18. Nicholl J, Williams B: Popular marathons: Forecasting casualties. Br Med J 285:1464–1465, 1982

    Google Scholar 

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The opinions and assertions contained herein are those of the authors and are not to be construed as reflecting the views of Walter Reed Army Medical Center, the Department of the Army or the Department of Defense.

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Baska, R.S., Moses, F.M., Graeber, G. et al. Gastrointestinal bleeding during an ultramarathon. Digest Dis Sci 35, 276–279 (1990).

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