Ischemic colitis due to vigorous physical exercise

Abstract

Physical exercise has been related with both beneficial effects on the gastrointestinal tract as with adverse effects on the latter. Gastrointestinal bleeding is one of these. In general, gastrointestinal bleeding is transient and mild. However, some cases caused by intestinal ischemia can sometimes be more serious due to the amount of bleeding and the presence of mucosal lesions. We present the case of a patient with abdominal pain and rectal bleeding caused by an extensive ischemic colitis due to vigorous physical exercise.

Ischemic colitis in an athlete: running is not always good for you

“…Ischemic colitis can occur in endurance runners (1)(2)(3)(4)(5); it seems more common in young women with little training (1,2). The gastrointestinal symptoms are usually mild (2).…”

'Runs' from a run: A case of exercise induced ischemic colitis

“…[13] World J Emerg Med, Vol 8, No 4, 2017 Physiological explanations for this phenomenon include an increase in sympathetic tone and shunting of blood, which can result in mesenteric blood flow being reduced by as much as 80% during peak exercise. [14] Traditionally, "watershed" areas, such as the splenic flexure and the sigmoid colon are thought to be the most prone to ischemia due to their limited collateral supply.…”

“…It is also important, with patients in this age range, to rule out other possible causes of rectal bleeding such as infectious colitis and infl ammatory bowel disease. [13] The diagnosis of exercise-induced ischemic colitis is largely a clinical diagnosis. Laboratory results in these cases are generally normal, however, in severe ischemia an elevated white blood cell count, lactate or LDH level can be seen.…”