~Has anyone ever had rectal bleeding after they finished running? I have been a runner for over 20 years and never experienced anything like this until the other day. I have recently been doing harder running workouts, not so much distance, just pushing harder and doing harder interval sprints and stadium steps. I average a distance of 5-6 miles and run daily. Last week I had 2 incidences of bloody diarrhea, both after a harder run. I have been running on an empty stomach with the exception of having 2 cups of coffee and a supplement of l-carnitine before I run. I also use an elliptical to do intervals at times, and never have the rectal bleeding then. If anyone has had something like this and can give me some advise I would truly appreciate it, as I am driving myself crazy with worry.
I know runners are prone to diarrhea due to the friction that is caused in our intestines from the running motion. However, you may have caused a flare-up in a condition called ulcerative colitis. I have had this for the last 4 years. If the condition doesn't clear up in a week or so, you may want to visit a GI Dr. They will probably do a colonoscopy. You will more than likely be put on a medication called Asacol. For me, I'm okay if I keep my workouts short and fairly easy. However, I'm currently training for a marathon and have been plague with your same symptoms since June. You're lucky right now that you can control your bowel movement until you're finished with your run. This may not be the case if you continue to increase your mileage and/or increase your effort level. Hopefully things will clear up.
Thanks so much for your reply and info. I had a rectal exam done and it was negative as far as any blood in the stool. My doctor now has referred me to see a colon specialist, so appears that I will be having that colonoscopy done sooner or later. I just hope this doctor has a bit more knowledge about runners, as my primary care dr. doesn't have a clue! They seem to be focusing more on anal fissures and internal hemmoroids. I dread all of this testing, as NOW I am afraid to run and haven't done so in 3 days!!! It's going to catch up to me soon & make me nutz as I haven't taken a day off of running since June.
~Thanks again for your response.
The above post is not accurate. GI bleeding after running has nothing to do with friction. When some people run, particularly long or very hard runs, the blood in your body gets shunted to the places it is needed most, namely your lungs and your muscles. Doing this, it diverts blood away from you intestines. When this happens you can partially necrose (kill) the superficial lining of your intestines, causing bloody diarrhea. Prior to becoming an avid runner myself, I have only heard about this happening to elderly people with bad vascular disease. Since becoming active in this forum, I have found that it has happened to quite a few people. Your story is classic: you have been running for a long time, but have just recently stepped up your workouts. One of the things you may want to try is keeping yourself well hydrated. That will keep your blood pressure from falling and reducing the blood flow to your intestines. Otherwise, I think you may need to train a lttle less intensely.
I know that may be asking alot, but is the great workout really worth crapping blood?
Just so you know, I am a board certified doctor who has seen his share of inflammatory bowel disease, and this is my opinion. However, "friction in the intestines' is flat out gibberish and makes no sense from a medical or physiological perspective.
Plus, your earlier comments about doctors are very judgmental. They are following the most logical and the most dangerous causes of rectal bleeding in humans. Just because you are a runner doesn't mean you are any less liable to have anal fissures, internal hemorrhoids or colon cancer than the next person. All of these things are easily diagnosable with a sigmoidoscopy or a colonoscopy. Plus, if they find cancer early, you will live to thank these "clueless" doctors."
That having been said, I stick with my above idea of your problem.
"Plus, your earlier comments about doctors are very judgmental"......
~ Thanks for you info it was very helpful and appreciated. As for your comment, I did not say ALL doctors, I said MY primary care doctor doesn't have a clue about runners. The reason as to why I made such a comment was when I said I had no other pain while running other than an occasional side stitch, she had no idea of what a 'side stitch' was.
I've been posting to the coolrunning message boards- I see rundiva has been there as well. Hope your scope is uneventful! I have been running distance for almost thirty years and the bleeding began about a year and a half ago. Dr. Mike's comments on this site are interesting to me as they seem to confirm everything else I have been able to find on this condition. And to his credit, stopping the intensity of my running is the only thing that stops the bleeding and at times intense discomfort. So I cross train a lot now, and keep my runs short and sweet and not more than two or three days in a row before I get on a bike or something less jarring. I can just tell some days that its not going to be a good run. Immodium often helps then, if I take it and wait a couple of hours before hitting the pavement.
I have experienced rectal bleeding after running which is pretty scary! When I told my doctor she just said it is probably a hemoriod that is on the inside. Now I am questioning this?? It is happening a bit more often on my longer runs and since I am training for a marathon I do need to train a bit harder than usual. I'm wondering if maybe I should suggest seeing a specialist? Your thoughts....
A couple of suggestions.. I respect your running experience, but I'm not sure if you are respecting it enough. You've built quite a base over the years and seem to be consistent. There really is no need to run every day any more. A couple of rest days a week should allow your aging body a better chance to heal, no matter what is getting overused or irritated. If you must do vigorous exercise every day, find a method of cross-training that uses your legs differently.
Another suggestion I would make is to avoid running stadium steps. There are other less stressful ways to strengthen hip flexors and hamstrings that are not as likely to tear anything down there.
My last suggestion is to avoid tempo runs, or runs of great intensity that cover more than a mile. If I can qualify for Boston without them, you can too. Keep your speedwork short and sweet, nothing more than mile repeats, and lots more sprints of less than a minute. Keep your longer runs on the easy side. You race will be your stressful tempo run, and the other workouts will prepare you for them without the wear and tear. In addition, your heart will thank you.
Regarding hemorrhoids, which is what I hope you have (vs. the other possibilities), there may be dietary or psychological approaches for dealing with them. Regardless of what is thought to be their cause, I had them during one of the more stressful periods of my life, and lost them when I learned to take things in stride and eat better. Take a load off, and stop beating yourself up. No one is more responsible, or in a better position to care for your body than you are.
There may be an allergen in your diet, or the fiber you are eating is too coarse (eg: wheat bran). IBS responds well after adjustments to diet and gut flora, in addition to lifestyle changes. You could charge up an enormous number of tests to fix the problem, or just experiment first. Regarding meds, are there any you may be taking that list your condition as a possible side-effect?
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