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Running-Associated Proximal Hemorrhagic Colitis

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The opinions or assertations 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 or the Department of Defense.

▸Requests for reprints should be addressed to Frank M. Moses, M.D.; Gastroenterology Service, Walter Reed Army Medical Center; Washington, DC 20307-5001.

Walter Reed Army Medical Center and Walter Reed Army Institute of Research, Washington, D.C.

Ann Intern Med. 1988;108(3):385-386. doi:10.7326/0003-4819-108-3-385
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Gastrointestinal bleeding has been seen in long-distance runners (1), but the source of this bleeding, when not of gastric or anorectal origin, remains obscure. Intestinal ischemia has been postulated as a cause of intestinal bleeding (2, 3). We report an endoscopically documented case of proximal hemorrhagic colitis associated with running.

Figure 1. Endoscopic appearance of the midascending colon (top) and the cecum and ileocecal valve (bottom) in a patient with gastro-intestinal bleeding.

A 42-year-old white man conditioned to run 5 miles daily was admitted for evaluation of abrupt abdominal pain and rectal bleeding after an 8-mile run. Aspirin, 1300 mg, had been taken 1 day before admission. Bilateral lower abdominal cramping pain occurred after he had run 5 miles. He continued running


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