Why Exercise-Induced GI Bleeds Occur in Endurance Athletes

Endurance athletes running a marathon

Being an endurance athlete is hard work, and there are many things that can go wrong in the body with repetitive and strenuous exercise. Although GI bleeds can occur because of a variety of complicated reasons, long and hard workouts are a common cause. Long distance runners, for example, commonly experience the troubling complication of GI bleeding. But unfortunately, many athletes are not aware of their own gastrointestinal bleeding and therefore do not seek treatment for it.

Here is an explanation of how gastrointestinal bleeding occurs in athletes and how this condition can lead to debilitating side effects, such as anemia.

Why Does the GI Bleed?

GI bleed symptoms can result from many conditions, including colon polyps, diverticular disease, hemorrhoids, peptic ulcers, and cancer. Gastritis often causes GI bleeds as well, which is brought on by the use of nonsteroidal anti-inflammatory drugs (NSAIDS), infections, Crohn’s disease, and severe injuries.

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Symptoms of Gastrointestinal Bleeding

Many marathon runners have experienced blood in their diarrhea, urine, and vomit after challenging races. Bleeding can occur in both the upper and the lower digestive tracts, but this amount of blood can be so small that it’s not even visible.

Upper tract bleeding appears as vomit that is bright red or that looks like coffee grounds, as well as stool that is black or mixed with dark blood. Meanwhile, lower digestive tract bleeding typically appears only as stool that is black, mixed with dark blood, or coated with bright red blood.

Causes of GI Bleeds in Athletes

Endurance athletes have a lot to worry about in regards to how their bodies function and recovery every day. But one question many of them have is what causes bleeding in the stomach.

Strenuous exercise affects the stomach and intestinal lining of the body and can weaken this lining over time. Research suggests that bleeding among long-distance runners may be due to gastrointestinal ischemia, a condition that makes it difficult for the intestines to work property and can create a loss of blood flow the intestines. Other theories address the fact that repeated jarring of the colon during exercise can cause trauma and contusions to the lower GI tract. Also, athletes who use anti-inflammatory drugs to manage aches and pains from working out are at a higher risk of developing gastrointestinal bleeding.

GI Bleeding and Anemia

As if blood loss through the gastrointestinal tract wasn’t bad enough, serious side effects can result if the condition is not promptly treated. One of the most common side effects of a GI bleed is an iron deficiency and anemia. This is because iron is lost with this type of bleeding, as well as the blood itself. For example, many athletes experience blood loss in their urine after exercise, which is a source of lost iron. In general, athletes usually have hemoglobin concentrations on the low end of normal. While this may actually be beneficial in reducing blood viscosity to deliver oxygen to their muscles, it also makes athletes more prone to the symptoms of anemia.

It is recommended that endurance athletes practice gradual conditioning and avoid taking pre-race aspirin to prevent GI bleeds. Therapy with iron supplements like Fergon, antacids, or H2 blockers may also be recommended based upon the symptoms of anemia and the GI disorder. Staying well-hydrated and making good nutrition choices before exercising can also reduce GI discomfort and stress in the body.

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