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Effect of cimetidine on marathon-associated gastrointestinal symptoms and bleeding

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Abstract

Occult gastrointestinal bleeding occurs in 8–30% of marathon runners. We hypothesized that cimetidine would decrease bleeding by reducing acid-mediated injury and conducted a blinded, placebo-controlled prospective trial to determine the impact of cimetidine on gastrointestinal symptoms and bleeding during a marathon. Thirty participants in the 1989 Marine Corps or New York City marathons completed pre- and postrace: (1) a questionnaire evaluating demographic, medication usage, training history, and gastrointestinal symptoms; (2) three consecutive stool Hemoccult (HO) cards; and (3) a stool Hemoquant (HQ). Fourteen runners (CR) took 800 mg of cimetidine by mouth 2 hr before the start and 16 runners (PR) took placebo. Three subjects were HO+ prerace and were not analyzed. Three subjects failed to take drug as directed and were analyzed as PR. Five of 14 PR and two of 13 CR were HO+ postrace (P>0.05). Prerace HQ values (PR: 1.49 ±0.6 and CR: 0.60±0.1 mg hemoglobin/g stool) were not significantly different from postrace HQ values (PR:0.73±0.2 and CR:0.86±0.2 mg Hgb/g stool). Despite postrace HO+ conversion, no individual postrace HQ became abnormal. The frequency of gastrointestinal symptoms was similar for CR and PR, as well as HO- and HO+ individuals. Cimetidine did not significantly affect occult gastrointestinal bleeding as measured by HO or HQ results. This suggests that marathon-associated gastrointestinal symptoms and bleeding may be due to lesions other than acid-mediated disease or hemorrhagic gastritis.

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Authors and Affiliations

  1. Gastroenterology Service, Walter Reed Army Medical Center, 20307-5001, Washington, DC

    Frank M. Moses MD, LTC, MC, Robert S. Baska MD, MAJ, MC, David A. Peura MD, COL, MC & Patricia A. Deuster PhD

  2. Department of Surgery, Walter Reed Army Medical Center, 20307-5001, Washington, DC

    Frank M. Moses MD, LTC, MC, Robert S. Baska MD, MAJ, MC, David A. Peura MD, COL, MC & Patricia A. Deuster PhD

  3. Human Performance Laboratory, Department of Military Medicine, Uniformed Services University of the Health Sciences, 20814-4799, Bethesda, Maryland

    Frank M. Moses MD, LTC, MC, Robert S. Baska MD, MAJ, MC, David A. Peura MD, COL, MC & Patricia A. Deuster PhD

Authors
  1. Frank M. Moses MD, LTC, MC
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  2. Robert S. Baska MD, MAJ, MC
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  3. David A. Peura MD, COL, MC
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  4. Patricia A. Deuster PhD
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Additional information

Work supported by: US Naval Medical Research and Development Command, Grant NN0007589 WR 00016.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army, the Department of Defense, or the Uniformed Services University of the Health Sciences.

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Moses, F.M., Baska, R.S., Peura, D.A. et al. Effect of cimetidine on marathon-associated gastrointestinal symptoms and bleeding. Digest Dis Sci 36, 1390–1394 (1991). https://doi.org/10.1007/BF01296804

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  • DOI: https://doi.org/10.1007/BF01296804

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