I have personally experienced what you may be going through - but at an extreme. I am a recent mother who had a goal to run a marathon and qualify for Boston in 2005. Well I did it - but guess what I'm not running Boston - or I can't - or if I do (as my doctor put it) I will bleed and if I keep bleeding my colon will die and then they will have to do some surgery, etc.

This is my story...
I started back running August 2004. September I was racing a lot and even into October (7 races in 9 weeks). I kept getting better so I kept pushing and I was also training for my marathon in December. I noticed blood after my runs when I had high intensity workouts (or races) or long runs. The first time this happened it was pure blood on the tissue and I thought I had my period back. Well I'm a breastfeeding mother so I was surprised it had already comeback (baby was only 3 months old at the time). Then I realized it was in my stool. I didn't have any cramping just loose stool and blood. There were times when the blood poured out instead of stool but I felt like I needed to have a bowel movement. I also began to back off on the water at this time because I would leak when I raced (pushed hard) and pee on myself. So I thought I would just hydrate during and/or after depending on the distance. I never kept up with how much water I was drinking during the day either. I remember noticing my daughter's urine was dark and strong but everyone said don't worry about it - your body will pull everything out of you to get what the baby needs for the breastmilk.

I finally went to my doctor because I have had relative that had colon cancer. Well a colonoscopy and a barium enema later nothing out of the ordinary and no solution.

Then I ran my marathon (not even six months after having my baby). I was on target to run faster than I ever have. Well about mile 4 I felt the need to go the bathroom (#2). Finally did at a portapotty at mile 7 - very bloody diarrhea - barely made it to the toilet. Then I thought good that's over with. Then at mile 15 it happened - the squirts is what it felt like. I had zero control of this sort of leaking happening. I just kept running wondering what I should do - hoping I might it would stop. Then I wondered how long my shorts would hold out - then I hoped I would see someone I knew so they could go get me some shorts. It was blood coming out and with 4.5 miles to go it started running down my legs. Well I wasn't going to quit then - I was worried I wouldn't have a chance to train for another marathon again with what was happening to me - and I decided I didn't care what anyone thought (I wasn't running this for anyone but me) so...
I kept going. By the way, people don't cheer for you when you have blood running down your legs they just turn away and act like they don't see you because they don't know what to say.

Anyways I finished and qualified for Boston. But ironically I'm not running Boston. 1/2 month later after being referred to another doctor I was diagnosed with Runner's Ischemia. It isn't very common - or if it is we just don't know it. It is extremely hard to find out anything on it. And I'm glad you have this message board to ask questions. My doctor doesn't seem to know a lot either. A friend put me in touch with one of her email running buddies and he had been diagnosed with this. His doctor said he could run again but never as fast as he wanted to. My doctor told me I could run Boston but I would bleed and my colon could die. This happened to an Ironman triathlete (Christopher Leigh). They had to cut out part of his colon.

My friend's email friend has been a tremendous help. He now runs faster than ever but he had to back way off initially. He started running slowly for several months and it took 6 to 8 months before he was up to speed again. He was also a very dehydrated runner. He now drinks 100 oz of water a day - and so do I. He hasn't had any set backs. I have. But I also bled for a longtime without being diagnosed.

I still breastfeed my daughter but her urine is clear now. So I was so low that it did affect her. Between the breastfeeding and the lack of water and ramping up too quickly I became ischemic.

Water will help the blood flow to the colon when the body is demanding blood to go to other areas of the body as you push yourself (distance or intensity). The breastfeeding also decreases bloodflow to my colon. There were so many factors that contributed to this that sometimes it is hard to isolate what I need to do as I go forward.

What I do know now is that water is EXTREMELY important and so is gradually building up. It makes sense and I've heard it all before but I had know idea what I was doing to myself.

Sorry this was so long but I want this to help people who are looking for answers to this rectal bleeding issue. I worry there are others out there who don't realize that they are hurting themselves.

I am having similiar problems! I'm a 44 year old mom now and have been running since I was 13. I have always had a hard time remembering to drink enough water and have gotten myself pretty dehydrated a few times. Then just last August I was building up for a 1/2 marathon and started having blood in my stools, coupled with an often crippling need to find a bathroom. Since the race in October I continue to alternate taking a week off and then trying short easy runs- the problems fire right back up. I have a follow up visit with a gastroenterologist next week. He did a sigmoidoscopy last September and found nothing wrong. He also seems clueless as to a potential "trend" among runners. Runners isochemia?- doesn't sound good. But at least it is a name! What sort of medical tests led to your diagnosis? I can't believe how hard you pushed your body, what with all you've had going on!

Thanks Aprilallyear for all the information you have collected. I have spent a fair amount of time looking at articles on the internet in regard to these symptoms and have found the need to stay hydrated listed again and again as an important safeguard to prevent damaging the mucousal layer of our colons. Most articles reference runners who are training hard, like you, for the exertion apparently channels blood flow away from the colon and triggers this bleeding and diarrhea.

I have such discomfort on my now intermittent 20 and 30 minute jogs where I am far from exerting myself, but never during an intense hour spin or elliptical machine workout. My discomfort and bleeding seems to be brought on by the mechanical jarring of running. Based on what I have read I'm going to have a try at a diet change. Lactose intolerance, bulky fibers and artificial sweetners have been named as potential causes for GI problems, as well as coffee and vitamin C. I'm going to stop taking anti-inflammatories (ibuprofen) and make sure I haven't had much to eat for 3-4 hours before running. And of course, I am going to drink lots of water! I'll let you know how that helps me. I wonder, do you cross train and do you experience these symptoms with lesser impact activities? (You might be interested in this article: http://www.cptips.com/smstrat.htm)

Hi - just checking in.

I want to respond to some of your questions:
The question I forgot to ask was if it would be ok to try Imodium or Pepto Bismol to prevent diarrhea on run day? Since this has come about, I'm very nervous and have diarrhea before I even begin running!

Don't do the Immodium. This is just my opinion but almost everybody that is writing in about this is dehydrated so Imodium will just make it worse.

The Ironman Triathlete is Chris Legh. My doctor thinks this is VERY serious and life threatening - at least that's what my Boston note says.

Thank you for passing on your doctor's fueling suggestions.

AGAIN - take a break from the running. It has taken me a bit to get used to this but I want to keep all of my colon. Start back slowly and make bleeding or that pressure feeling in your rectum your guide. I found that running a minute slower than my marathon pace is what I could handle for short distance runs. This is really serious so take care of yourself for the "long run."

More later...

Interesting topic.
I recently read an article about Paula Radcliffe. In the interview, she said that during one of her marathons, she had these same symptoms. She said that the symptoms hit her the worst after the finish, because she felt like she had to use the bathroom while she was running, and didn't want to lose any time, so she didn't stop.

This problem must be more common than we realize among high performance runners.

Thank you to tajarus!!!!! Since your last message I have given up my 2-3 lattes per day and I have been running perfectly comfortably! I have always drinken a lot of coffee and a lot of milk, and relatively little water I guess. I am taking all of the advice you quoted from your doctor, and I am so happy to be running again. Running has been my "thing" for the past 30 years and having to stop was awfully upsetting- I had been having my problems since last August. Hopefully you have cured me... and you are saving me a fortune at Starbucks! Thanks!

Just to let you know, my troubles aren't gone after all. I've been sticking to my plan of no dairy no coffee, lots of water/ no meal before a run... But I'm having slightly bloody loose stools after my runs the last two days. Maybe the little bit of dairy and caffiene that comes in sodas and baked goods? I am frustrated.