Fecal Occult Blood in Marathon Runners
Gastrointestinal (GI) complaints and low intensity GI bleeding frequently occur in marathon runners. Strenuous exercise, particularly in elite athlete runners and less frequently in other exercise activities, can cause acute incapacitating gastrointestinal symptoms including heartburn, nausea, vomiting, abdominal pain, diarrhea and gastrointestinal bleeding. Approximately one third of endurance runners experience transient but exercise limiting symptoms, and repetitive gastrointestinal bleeding occasionally causes iron deficiency and anaemia. Runners can sometimes experience significant symptoms including hematemesis. Exercise is associated with extensive changes in gastrointestinal (GI) tract physiology, including diversion of blood flow from the GI tract to muscle and lungs, decreased GI absorption and small intestinal motility, increased colonic transit, neuroimmunoendocrine changes in hormones and peptides such as vasoactive intestinal peptide, secretin and peptide-histidine-methionine. Substantial changes occur in stress hormones including cortisol, in circulating concentrations and metabolic behavior of various leucocytes, and in immunoglobulin levels and major histocompatibility complex expression. Symptoms can be exacerbated by dehydration or by pre-exercise ingestion of certain foods and hypertonic liquids, and lessened by adequate training.
Ingestion of 800 mg of cimetidine 2 hr before running a marathon did not significantly affect the frequency of gastrointestinal symptoms or occult gastrointestinal bleeding. Conversely, 800 mg of cimetidine 1 hr before the start and again at 50 miles of a 100-mile running race substantially decreased GI symptoms and postrace guaiac test positivity but did not affect race performance.
Additional studies have reviewed the effect of cimetidine and of PPI
Role of endoscopy in marathon runners with positive FOBT
This is a different process than march hemoglobinuria.
Read more about this topic: Fecal Occult Blood
Famous quotes containing the words occult, blood, marathon and/or runners:
“There is no more foul or relentless enemy of man in the occult world than this dead-alive creature spewed up from the grave.”
—Guy Endore, and Tod Browning. Prof. Zelenn (Lionel Barrymore)
“No person connected with me by blood or marriage will be appointed to office.”
—Rutherford Birchard Hayes (1822–1893)
“The mountains look on Marathon—
And Marathon looks on the sea;
And musing there an hour alone,
I dreamed that Greece might still be free;
For standing on the Persians’ grave,
I could not deem myself a slave.”
—George Gordon Noel Byron (1788–1824)
“Why runners make lousy communists. In a word, individuality. It’s the one characteristic all runners, as different as they are, seem to share.... Stick with it. Push yourself. Keep running. And you’ll never lose that wonderful sense of individuality you now enjoy. Right, comrade?”
—quoted in Guardian (London, Dec. 29, 1984)