SUMMARY A 34 year old female long distance runner is reported with bloody diarrhoea. Colonoscopy revealed patchy haemorrhagic mucosal lesions throughout the colon. The most extensive lesions were found in the sigmoid colon. Histologic examination disclosed mucosal haemorrhage, dilated capillaries, patchy fibrosis and superficial erosions. Additional findings in this patient were haemorrhagic gastritis, microscopic haematuria and rhabdomyolysis. The only medication taken by the patient was oral contraceptives. We conclude that ischaemic colitis is one of the possible mechanisms leading to gastrointestinal blood loss in competitive runners.Abdominal discomfort and alteration in gastrointestinal function are common in runners. Twenty five per cent of runners had abdominal cramps or diarrhoea in association with competitive running.' Although occult gastrointestinal bleeding seems to be quite common2" bloody diarrhoea remains a rare event.' The pathophysiology of gastrointestinal bleeding during physical exercise is poorly understood, but bowel ischaemia has been proposed as a possible mechanism.2"' We report on a female long distance runner with a bloody diarrhoea syndrome caused by acute ischaemic colitis.Case report A 34 year old female long distance runner was referred to our hospital because of bloody diarrhoea. She competed in a 15 km mountain race; the altitude ranged between 540 and 870 m and the temperature was 14 to 18°C. At 10 km she experienced generalised severe crampy abdominal pains, forcing her to stop the race. During the next hour she noted bloody red stools, over the next few hours she subsequently vomited and noted small portions of blood. The same day she was referred for clinical evaluation. The patient had been in good health all

Tumor ingrowth is not a major cause of stent obstruction.

6 patients with severe symptomatic diabetic gastroparesis were studied in a placebo-controlled randomized manner to establish if intravenous domperidone accelerates the delayed gastric emptying of a semisolid homogenized meal. Domperidone, 10 mg intravenously, shortened the gastric emptying half-time in all of the 6 patients significantly, but not in the healthy control subjects. These results suggest that intravenous domperidone may be potentially beneficial to diabetic gastroparesis patients by improving delayed gastric emptying.

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A case of colonic pneumatosis cystoides intestinales (PCI) which occurred three days after a routine colonoscopy is presented. A review of the literature revealed only two other cases of PCI following colonoscopy. The close temporal association to the colonoscopy supports the mechanical hypothesis as the probably mechanism leading to intramural PCI.