Anyone hear of this or been diagnosed with same? If so, I would be interested in hearing how you deal with it and continue running.
Since I've been training for a half-marathon and gotten into a longer distance than my usual training (normally train for sprint triathlons), I've experienced GI bleeding. I will be going for some tests in a couple of weeks - doctor said I could still run but to stay highly hydrated. It is causing me discomfort and concern. Just wondered if anyone had any experience with this.
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.
Thank you for posting this topic. I suspect more people have this problem, but it is embarassing and a bit scary to talk about. I am fairly new to running and training for my first half marathon at the end of next month. My long runs are up to 9 miles. For the last two weeks I had the problem of bleeding at about the 6-7 mile distance. Little "squirts" bloody and a little loose stool. When I finished running and went to the bathroom, one final "squirt" and it is over. I do notice a lot of lower rectal pressure at the end of the run and for about an hour after running, but then I seem OK. Do you think more water will help. Any suggestions anyone has would be so helpful. thanks
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!
Hello everyone! I just lost everything I typed so here we go again.
The first thing I want all of you to do is go get some water! Now drink it! I keep a 100 oz. jug in my kitchen and drink out of it all day. Do whatever it takes to stay hydrated (because according to your emails there is a pattern here).
You may also want to back off from the running. Take a week off or a month. Cross train. I am currently water running and doing revcycle classes. Or back off on your intensity. Yor new running pace needs to be so slow you feel like you could run forever.
None of what I'm telling you is necessary unless you have the runner's ischemia so really the first thing you should do is get tests.
I was very lax about going to a doctor because I had heard about others bleeding when they ran. hen I read an article about a runner who had similar rectal bleeding and ended up with colon cancer. My grandmother had colon cancer so I went to the doctor. He sent me to a group of colon/rectal surgeons he knew and liked. The doctor there ordered a colonoscopy. He did the colonoscopy two days after my worst episode of rectal bleeding (PR'd an 1/2 marathon). He found an irritated rectum and biopsied it but he couldn't get around one of the bends in my colon so he could only see the descending side. He ordered a barium enema. Nothing irregular came back. In the meantime I ran my marathon. Up until this point I had only bled after I ran (even after a 20 miler). So as you know I bled during my race. I actually didn't have any pain just very uncomfortable because of the leaking.
Pause: I thought at this point it would be important to tell you that I train using Jack Daniels Running Formula. I didn't get to do all the weekly distance he prescribed but I did do the intensity in the workouts (I also had to pick up on his training in phase four because of time limitations). This I believe is important because when I did my long training runs I was always running a minute slower than my projected marathon pace. Do any of you train this way? I know this is a trend advised by alot of the coaches and authors.
Back to the story...
So I am running faster than usual for this distance - running about as fast as Jack Daniels said I could. Well you know how it ended. WEll luckily I had an appt. with my doctor that Monday. He sent me to a Gastro doctor and recommended another colonoscopy. I saw the gastro dr. the next day and he said not to worry I just needed a stool softner and I would be better - come see him in a month - and sign up for Boston. I can't tell you how excited I was! It didn't really make sense to me though since my stool was soft. Well three weeks and one Boston application later I was back at the gastro dr. office. I had been bleeding after my runs. He said he had done some investigation and thought I had runner's ischemia. He ordered a vascular ultrasound to ensure there was no bleeding coming from any arteries (I hope I'm getting this part right). No everything was normal. Well I was in a state of shock. Depressed. Mad. You name it! Actually I still am.
Well after some networking I found my friend's email buddy. He was actually hospitalized after the first time it happened to him. He started back running slowly mileage and intensity). He hasn't bled since. He has run up to 100 miles per week at times and is faster than ever! (There's hope!)
I have tried to go back to running. I have either screwed up because pushed a little too hard or didn't drink enough or ate before I ran. Last week my gastro doctor did another colonoscopy just to ensure there wasn't anything else (and I had just bled). He found nothing.
So drink water now! It can't hurt. In fact if any of you know anything about maximizing water absorption I would appreciate the info.
Also. If you bleed don't run. If you have to run don't bleed. But taking time off will only make you better.
I'll keep checking back!
Mt doctor's note to Boston marathon committee was that I had a life threatening issue and his words to my mother after my colonoscopy said that my health was at risk.
I have another idea. I would like to get Runner's World or Active to do an article on this so I am going to send them my information. If any of you could send them any inquiries or your info. it may be helpful. Also if you find a doctor that has a good grasp on this let me know. Dr. Bob Laird is who diagnosed Chris Legh at Ironman Hawaii with exercise-induced ischemia. He had part of his bowel removed three days after his race but came back and placed second the next year. I did hear he does have some reoccurring issues though. I would love to find out more.
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)
I had checked back to this board a couple of times and no one had responded, so I quit checking. Now I see a lot of you have experienced exactly my same symptoms. It's good to know we are not alone - however, no relief seems to be in sight AND there are differing opinions on the health risks.
My ob-gyn told me her friend almost died from it and said I had to go get a colonoscopy. I did that today, and the gi doctor (also a runner) said everything looked good and that I could keep on running. He said it is a common problem amongst long distance runners.
I've been training for a half marathon and find that my problems begin around 5-6 miles out - sound familiar. I was told to stay very hydrated - which I do. Most of the time after my run, I would have a bloody stool and that would be the end of it. I just ran 10 miles on Sunday and suffered through the last two miles with a lot of pressure and no bathroom - when I got home, I had a lot of bloody diarrhea and it kept up for several hours afterwards.
Here are the suggestions from the gi doc:
1. Only have a liquid breakfast (< 500 calories on long run days)
2. Stay hydrated throughout the day
3. Drink only water for runs less than 2 hours
4. Avoid caffeine
5. Don't have milk or fructose on the morning before a long run
6. Eat your big meal at lunch the day before a long run instead of at dinner
7. try to have a bowel movement in the morning before you run
Try to use gels and sports drinks that DO NOT contain fructose or caffeine.
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!
I was trying to remember the Ironman athlete that had the problem, I remember reading about it in Inside Triathlon (I think, but couldn't find the issue).
Anyway, I agree with asking active.com or Runner's World or one of those publications to expound on this problem.
One other thing that might help is to take a multi-vitamin with iron - it will help replace the blood loss. Seemed like I was doing better with that, but had to quit taking it for the colonoscopy. I'm going to go back to that to see if it helps.
Hope everyone stays in touch with any findings. Thanks for your responses and good luck in your endeavors.
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."
I'm so glad that I am not imagining things! I am a newer runner and am training for my first marathon. I get terrible cramps, bloody stool, and diarrhea that set in about an hour after I am done running. it only happens after races (10k's) and a little after long runs. I'm guessing that dehydration is my biggest issue. I have a friend that takes immodium right before her marathons and has had great success with that. I found that Bloody Marys after a race DO NOT help in any way... probably the dehydration factor.
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.
Thanks for the advice in this topic. I tried it and it worked. I just finished my first long run (11 miles) without having this problem past the 7 or 8 mile mark. I didn't even feel the urge to go or the usual pressure down there. Let me tell you what I did. Increased my daily water drinking to where I always have a water bottle or glass of water sitting near by. For the two days before my run, I made up a pitcher (72 ounces) of ice water with lemon and made a point of drinking the entire pitcher through out each day. My meal last night was sloppy joes on whole wheat bun and pasta salad at 6:00pm with no solid food after that. At night I put a large glass of water next to my bed, and each time I woke up or rolled over, I took a drink. it was gone by morning. (had to pee twice during the night which I normally never do). I got up at 5:30 and had a cup of coffee right away. Coffee always gets my bowels moving in the morning. My goal was to empty what may have been in there and not add any more solids until after I ran. I then had a glass of gatorade and showered to wake up. I started to run at 6:45 and went slow, walking a minute for each mile I ran. Other than feeling like I had to pee a lot at the beginning (the first three miles or so) I felt great the whole time. I drank at each walk break alternating between gatorade and water and did a gel pack with water at the half way point. I am convinced that hydration is the key. Thanks for everyones imput on this topic. It helped me so much.
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!
Glad this thread has produced some positive results - including myself. I ran in a half marathon race yesterday with absolutely no cramps and no bleeding. Followed the advice from my doctor, which must've done the trick.
I'm so happy, that perhaps I won't have to worry about something bad happening every time I run - of course, being careful to follow the guidelines to stay healthy.
Thanks to everyone who participated in this thread - it was helpful knowing I wasn't out there alone.
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.
I have been an on and off runner for years - and had major bowl problems. It culminated about 5 years ago when I found I was bleeding after a run, I had severe cramping, feeling like I needed to move my bowls. A colonoscopy later led to a diagnosis of ischemic colitis - that the running was taking blood from my colon, causing bleeding from the irritation.
I have had other digestive problems. Duadonal ulcer and constipation. One big reason was probably that I tend not to consume enough water and consumed too much caffeine.
But here is another thing to consider. Recently I found out that I have a food allergy - in my case it is eggs. It seems that a food allergy will put so much stress on your digestive system it can introduce all kinds of problems. When I stopped eating eggs, I stopped having all of my digestive problems. I suspect that my ulcers and other problems were caused, at least in part, to consuming foods that my colon could not process. Such allergies are not obvious and can only be identified with a special blood test I was able to have ordered by my chiropractor / nutritionist. You tend to crave the things you are allergic to. Needless to say I miss my eggs!
Hope that helps with identifying cause. Other allergies (like wheat) have the same affect.