Coagulability and Rheology: Hematologic Benefits From Exercise, Fish, and Aspirin. Implications for Athletes and Nonathletes

Portal Venous Thrombosis in a Backpacker

In brief Effort thrombosis usually afflicts an extremity and is caused by compression. This case report, in contrast, involves superior mesenteric and left portal vein septic thrombosis in a backpacker following prolonged hiking and abdominal straining. The condition may have been caused by localized splanchnic venous ischemia, erosion of the bowel-blood barrier, and release of bacterial endotoxin in this dehydrated and detrained athlete. Diagnosis of this disorder is aided by noting characteristic abdominal pain, fever, nausea, and vomiting, as well as by imaging with MRI, CT, or duplex ultrasonography. Antibiotics and anticoagulants are key to treatment.

Occult Gastrointestinal Bleeding in Endurance Cyclists

In brief Gastrointestinal (GI) bleeding has been well documented in long-distance runners but not in cyclists. The disorder is thought to occur in other strenuous endurance sports as well. The purpose of the present study was to identify the incidence of occult GI bleeding in a large group of endurance cyclists who participated in the 7-day Bike Ride Across Nebraska. Of 500 participants, 35 submitted 163 stool specimens during the first 6 days of the ride; only two specimens, from two riders (1.2%), were positive for occult blood. GI bleeding deserves further research to determine the incidence and cause or causes of this intriguing problem among athletes who engage in strenuous sports.

Gastrointestinal Bleeding in Athletes

In brief: Gastrointestinal (GI) bleeding is a troubling yet intriguing complication of distance running. This clinical overview traces our evolving understanding of the scope and importance of GI bleeding in runners and other athletes, and discusses the diverse causes, sites, and implications of exercise-related GI bleeding. It concludes with practical tips to prevent or mitigate this problem, including gradual conditioning, avoidance of prerace aspirin intake, and when indicated, therapy with antacids, H2 blockers, or iron.