Ischaemic colitis in an ironman triathlete: A case report and review of the literature

Abstract

Participation in endurance sports is growing and gastrointestinal complaints including abdominal pain and rectal bleeding are common. The most severe lower gastrointestinal complication of endurance sport is ischaemic colitis. Only a few cases have been reported, all in amateur long distance runners. The majority of cases involve the right colon and, if diagnosed early and managed appropriately, few patients require operative intervention. A 51-year-old male presented 24 h after completing an ironman triathlon with severe right-sided abdominal pain and bloody diarrhoea. Computed tomography confirmed right-sided ischaemic colitis. Conservative management with intravenous rehydration and antibiotics led to the complete resolution of his symptoms over a 72 h period. Participation in endurance sport is increasing and awareness of its complications is important. In the case of ischaemic colitis related to extreme exertion, early recognition and appropriate management will decrease the risk of potentially life-threatening complications.