Anal bleeding with running

I have an issue that so far no one has been able to shed light on, including 2 very reputable GI physicians in the area. Kind of strange... I've been a runner since high school and after my surgery I started having some slight anal bleeding right after running a few miles - not always, just sometimes.

It's progressed to now, where the bleeding starts as I'm running and I can feel it build up in the pouch so have to stop due to the pressure. These are slow, light runs, only 2 miles or so, and I'll eliminate blood just once and there's no other occurrence until/if I run again (Not sure how much blood; once it's in the bowl it's hard to tell and sometimes is with stool. But if I had to guess I'd say 1/2 pint or less). Needless to say, I've stopped running entirely due to how distressing it is. But this is an exercise I love, and would love to get to the bottom of it! Thanks for any insights you may have.
 
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Ok, stupid question time: what kind of runner are you?
Do you run 'high impact', light steps, jogging, sprinting...?
What I mean is could it be related to the way you run and not the fact that you run...? I have a 'heavy step' when I run and have to correct it otherwise I 'thud' when I put my foot down...not good...so I have changed to toe-heel instead of heal-toe. It causes much less impact for me and I don't feel everything shaking up inside...
So that is the question really; how much are you shaking up your pouch and what is bleeding when it is shaken? Is it the vibrations or are they micro tears? I would try another 'high impact' exericse and see if it does the same thing (try jumping rope for 3 mins at a time and see if you have the same result)...if so you know that it is the impact that is doing it...and you may have to switch to stair or hill climbing.
Sharon
 
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Thank you for your questions and thoughts - much appreciated! I don't go for speed anymore; there's something to be said for enjoyment... no pain, no pain ;-). So I'm more of a jogger and my form is good. Not a heavy stepper, but the exercise itself I guess is jarring - maybe too much. Other aerobic activities don't have this effect (eg, the "Insanity" workout, similar to P90X; elliptical/stair climbers, etc).Unfortunately I have no idea what exactly is bleeding; nothing that my GI physician can discern.

There's an annual fun run that I love to do, but it's 6 miles and the light training I do for it is problematic. I really hate to give it up but sounds like at this point I should. Bummer, but I can try some new things and see how it goes. Thanks again.
 
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Sue,
I would honestly keep an exercise diary for a while...what activity you do, for how long you are doing it, under what conditions (before or after eating, emptying your pouch, drinking, morning or night etc...) and then the results of what happens to your pouch afterwards...you may figure something out that way...bare (sp?) in mind that you are your own best doctor/diagnostician and that you know your body best so you are in the best position to monitor it...you might also want to track stuff like what you are eating that week (certain foods are seasonal and may effect you differently like fruits or veggies)...
I don't have any better advice than that...I had asked Jan about skipping rope and she suggested that I avoid it because of the impact factor and my pouch...so I am back to climbing stairs to get the 'thrill' and adrenalin rush.
Good luck
Sharon
 
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I'm 4 months out from my takedown and started to run just a little bit too..nothing crazy and same thing happens to me. I wouldnt give up..another poucher I talked to who's not on this forum, same thing. I ran it by my GI he didn't seem alarmed, he explained it as if the running may cause a bit of inflammation. I'm seeing my surgeon for follow up next week and will ask him his thoughts too.
 
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I have the same problem. It started when I was training for a half marathon a couple years ago. It was intermittent at that point. But now, anything over 3 miles and I'm bleeding. Same scenario - hurts while running, blood the first time I go after, and then no more blood. My doctor scoped me and couldn't find anything specifically wrong. So I'm taking a break for now and will try to keep the mileage low. Would love to hear if you find something that helps.
 
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Thank you, Sharon, Randi and Meredith! Sharon, great ideas regarding tracking the specifics. It's not my strong suit but now that you lay it out, it sounds very worthwhile to do. Great suggestions.

Randi and Meredith - so sorry you're dealing with the same thing. Let's do keep each other posted with any news or other ideas that we find. Randi, would love to hear what your surgeon says.

I could learn to deal with the inconvenience and try to minimize it more, but I don't want to be doing some kind of damage unknowingly.
 
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Sue- saw my surgeon today and discussed this with him. He has heard of this happening. He didn't seem concerned and didn't discourage running either. He didn't offer a clear explanation as to why it may happen but I think if just a little blood came through only in our first bm after a run, I doubt damage or anything serious is going on. I doubt I'm going to pursue running anyway as my strength has not come back fully. I've been enjoying yoga classes lately.
 
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I have the same problem. I usually run on a treadmill, and every time I do, I get bleeding. It's not very much, but I do feel it happening while I am running. No other instances of bleeding at all. I too asked my surgeon about it, and he didn't seem to think it was anything to worry about. Just said it could be some irritation while I'm running.
 
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I have had this happen on a couple of occasions during/immediately after a run. Once, there was a fair bit of blood. I could feel it while I was running, and when I got home and used to washroom, there were probably a couple of tablespoons of bright red blood. As others have mentioned, my surgeon chalked this up to irritation/hemorrhoids and felt I didn't need to be concerned unless it started happening all the time. I run 3-4 times a week and this has happened just a couple of times. I wish we had an answer for this!
 
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Good to know that it's apparently not serious... but so interesting and curious that it affects a number of people. I have an appt end-Nov for annual scoping and my doc has this in mind. I'll report back, though from what I can tell from everyone's posts here he probably won't have anything conclusive to say. We'll see.
 
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well now 1.5 years after the conversation ended, I'm seeking the same information. But, what I find strange is that I ran during the first 8 months after having the take-down and nothing of the sort. And then I ran 4 years afterwards and nothing... then 10 years after and nothing. However, 12 years later, I find the same thing happening over the past month, in the time I've added running to my regimen. It happened something like every 1.5 weeks and after I had increased the intensity or time lapse of the run. But, then it occured yesterday and today (no 1.5 week break in bleedings) and, yes I increased the intensity and timeframe yesterday and today (today, not the intensity, but the timeframe -- 1.5 minutes more -- yes). I've read all of your comments and am finally feeling thankful for having read something calming. And, yes, it is calming all that you said, although seemingly so long ago. I am curious though if "you" continued running and, if so, how was the trajectory regarding the bleeding...?

Ross
 
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Morning

I am also having woes with rectal bleeding following speed walking and bike riding.I am awaiting path reports .For me it started in January
Gastro Md stated pouch looked good when I was scoped last month.

Any other with input would be greatly appreciated.
Cassiecass
 
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Sooo glad I'm not alone on this one. I've been running for years, all after surgery and the bleeding is only a recent thing. Same situation as others, only blood when I empty my pouch immediately after my run then no more. I had a scope a couple of months ago and everything was fine but there was a "floppy" bit in my pouch which I was told was just one of those things that happens and is nothing to worry about.

I was assuming that was causing the bleeding and had put it out of my mind until a recent race where I felt like my body was shutting down as I ran. I turned out to have iron deficient anaemia.

Feeling quite low as I'm in the process of taking my iron tablets, trying to build up my stores, but not wanting to risk running just now and delay my recovery. It sucks because I was supposed to run a half marathon for the first time next month, but that ain't happening now.
Would be interested to hear how everyone else's stories have turned out, bearing in mind how old the original posts are!
 
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Could it be the staples which "bruise" the pouch when running, so blood come in? Did you know we have still our metal staples (if not handsewn) in?
 
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Still have metal staples in? I'm really not sure! I've had my pouch since 2001 and it's never been mentioned, but they also didn't mention that they recommend a cesarean for my first child so I wenr merrily on having a normal birth! Interesting, I have an appointment in May so I'll ask..or I might just take a magnet to my belly and see if it sticks ;-)
 
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surgical staples are composed of either stainless steel or titanium, both of which are not magnetic.
 
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Sorry, just my sense of humour, I was joking about the magnet! :-)
 
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Smiler
 
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Maybe it's a delayed 2dk (year 2000) phenomena and we should put on Prince's 80's hit "1999"... As for Stephanie and I, J-Pouch babies of 2001 (my surgery in NYC on Halloween 2001), maybe it is "Bin Laden's Revenge"... Actually, I find it interesting (at Stephanie's expense) that she also is experiencing this phenomena 11-12 years later... But, I do find the comments reassuring, being that there aren't J-Pouch specialists here in Mexico. What I don't find reassuring is your anoemia and what happened to you during the race. My younger sister just had her J-Pouch surgery after being diagnosed with Rectal Cancer (she and I inherited my father's or paternal grandmother's FAP/Gardner's Syndrome; she just turned 43 and is marathoner and was told she could return to running 1.5 months after the initial surgery, which surprised me.)

Stephanie, I hope the situation for you changes regarding the bleeding, anoemia and your running.

Ciao IKH
 
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Aw thanks, do love a bit of Prince! To reassure your sister though, I have run for many years without any problem so she should be fine. I thought I was just struggling to get my fitness back after xmas but it was obvious during my race it was more than that.
I'll keep you up to date with how they decide to treat me. Definitely feeling more alive with the iron tablets, but not quite up to fitness to run yet.
 
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Thanks Stephanie! I'll relay the information to Beth... I believe she's registered here on J-Pouch
 
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Beth, that's my daughter's name too! Good luck to your sis for her marathon (and the training!). X
 
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When I first entered the conversation a few months ago, I wasn't finding any information more than what you guys offered, which was very encouraging for me. Granted, it was saddening hearing from Meredith and Stephie that they had to put the running on hold.

For some strange reason, this past week I easily encountered explanations for the anal or rectal bleeding in on-line runners magazines: http://www.runnersworld.com/ru...ches-rectal-bleeding

Supposedly 17% of marathoners experience significant rectal bleeding after the marathon that dissipates gradually over the next few days. If I'm correct, not all of the experts mention marathons but long distance running. The general explanation for why almost 1 in 5 runners experience rectal bleeding is during the run, blood is greatly directed towards the muscles and away from the intestines (called ischemia) causing the rectum or the colon to shed some of its exterior lining. Sounds a bit gross. But, at least it is not considered a serious issue... Other causes for bleeding are hemorrhoids, which I imagine are very prevalent with J-Pouchers, especially if they experience thick stools... but your doctor would have seen this if it were your issue.

The even more important reason I'm writing today is because I stumbled across Nopal (*****ly Pear) cactus paddles as a preventative and/or cure for ulcers (the gooey-mucousy sap called "mucilage"; similar to that of okra). http://www.organicfacts.net/he...getable/nopales.html The mucilage creates a protective lining of the digestive tract, preventing ulcers or helping cure them (protecting the wound). Granted, we aren't really talking about ulcers with the J-Pouchers who had their pouches scoped after the incidents. But something is being "opened" releasing the blood. As the Runners World magazine mentions, one way of helping the issue is preventing dehydration, which is an issue for J-pouchers. As you may understand, mucous also helps with maintaining moist the mucous membrane of the digestive and respiratory tracts. Mucilage is plant mucous.

Along with Turmeric, Cactus paddles are considered the #1 natural anti-inflamatory on the planet. I started cooking with nopal cactus paddles in April and May and took a break from cooking them for at least a month. What I noticed during that time is that when I had upped my run to above 30 minutes in June, I started bleeding again for a few bathroom stints that day and all the runs afterwards. I increased my run to 40 minutes last week and found myself bleeding horribly almost the whole night after the run. And then I remembered the cactus paddles and began cooking with them again on Tuesday (my day off from running). Yesterday and today I ran 45 minutes each day and found no blood.

I hope you are still running or that you find this information helpful.

Ross
 
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The first article was very interesting. My Gi and surgeon both "banned" me from Pilates due to rectal bleeding and an increase in abdominal scar tissue that showed up on an MRI. I am training for a half marathon now and have small amounts of rectal bleeding a couple of days a week. I've just decided to live with it since the doctors do not know what causes it. There is no pain with the training but I often had very bad abdominal pain during Pilates classes.
 
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About staples...
To bleed after a physical exercise has always been an important problem with my J pouch. I have this Jpouch for 22 years and the anaemia was almost always a threat. From the beginning we suspected micro bleedings. But with time, they became very visible, and mostly after doing physical activity. Now bleedings are so important that now I can't do any physical activity ( even walking for 15-20 minutes). The numerous scopes I had didn't show the cause of these bleedings. It is only 2 years ago that a surgeon who scoped me found that the blood was coming out from the staples (as Ikh says).

I am now waiting for an ileostomy.

Rich M
 
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If you are truly concerned about the bleeding and exercising and don't need to spend so much money on another surgery and the inconvenience of an ileostomy and you can find Nopal (cactus paddles) in a whole foods supermarket, why not try putting cactus paddles in your diet? It makes absolutely no sense suffering unnecessarily because eating cactus paddles seems foreign... especially if they help prevent the bleeding. Truthfully, a J-Pouch is much more foreign than is eating cactus paddles... but for some reason you are living with a j-pouch. Just so you understand, I live with a J-pouch; am from the New York/New Jersey region, but living in Mexico for 11 years. I didn't start eating cactus paddles until April-May. They removed the bleeding from the exercise until I stopped eating them late last week. Yesterday I increased the intensity of my run and experienced serious bleeding. The irony is that I had bought Cactus Paddles around midday, but didn't cook with them. I don't believe it is necessary that I cook with them every day. But, I do believe that as long as I am increasing the intensity of my runs, I must have them in the diet at least every-other-day. Not such a great sacrifice considering the relief I achieve along with the cost effectiveness. Plus, considering their nutrient value and the fact that they are #1 next to Turmeric for natural anti-inflamatories... I would imagine that the J-Pouchers tend towards being middle-class, college educated survivors in first-world countries, well-immersed in the realities of modern disease and chronic illness. That means that you should well understand the risk of inflamation in all modern chronic illnesses and disease subsequently sparking interest in foods that decrease inflamation... What if you don't need to stop running... What if you don't need to have the ileostomy? All that is necessary is a calibration of your diet...
 
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Yesterday was my day off from running. But, I put the cactus paddles back into the diet. Actually, this time my wife Margarita prepared them in a cream of broccoli/zuccini/nopal cactus paddle soup prepared without cream or natural yogurt. Unlike me, she uses much fewer of the cactus paddles, partially to my shagrin... But, I was in the middle of "doing the books"... Today I ran 49 minutes... Not a drop of blood... You can place the cactus paddles in any dish keeping in mind that their under-cooked flavor is a slight bit tart (what I call "green" here in Mexico)... I wouldn't worry about over cooking them... Cook them to death if you wish. They continue working as an anti-inflamatory and anti-ulcerant etc... Remember that nopals are mucousy from their mucilage just like Okra. If you don't have a problem with okra... if you do, I suggest you get over it just as I got over it... It may be the only true natural remedy you can find that enables you to relax in the bathroom and continue running... the following scholarly articles I'm posting are on mucilage (not necessarily from cactus paddles):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074307/

This is a wonderful piece: http://cornersofthemouth.wordp...age-by-karin-uphoff/

http://www.healthbenefitstimes...fits-of-nopal-fruit/
 
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Yesterday I bought flax seeds and ground them in my Vitamix blender and began sprinkling them on all of my food. The bowel response is incredible! This morning I prepared the nopal (*****ly pear cactus paddles) with bacon, onions and garlic (much more cactus than my wife Margarita used yesterday). Udo Erasmus of "Fats that Kill/Fats that heal" claims that the sulfur in onions and garlic controls free radicals caused by the extreme heating of oil. This evening I ran the same 49 minutes but increased my distance .5 kms (3/10ths of a mile). Day two running and eating nopals without seeing a drop of blood...
 
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It's been at least a week since I last prepared and ate the cactus paddles. But, I've been mixing into my food at least 6 tbls of ground flax seeds per day. During this time I've also increased my running time to 63 minutes. No bleeding. Which means that the mucilage in the flax seeds works equally well as due nopal (Pricly Pear -- if I spell the word correctly they edit me as if I were writing a profanity *****ly Pear, which is it's actual name and not refering to genitalia but to spines that ***** your finger just as a doctor would ***** your finger with a needle to draw a little bit of blood...) for preventing J-Pouch bleeding while running. But, it is clear that no one truly is interested in preventing bleeding instead of preventing running...
 
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Sorry to come to the party late, just saw all these fantastic posts. I've started running again, anaemia gone for the mo. No explanation but I think these posts explain it all. Not back to my previous long distance but building up slowly trying not to go backwards. Def going to try some of these solutions- if I can get hold of them without emptying my purse! Back to the consultant in sep so hopefully test my anaemia and come up with a long term plan for my iron levels if necessary. Everything seems fine at the mo- no bleeding. It's just amazing running again without being in slow motion!
 
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Actually not so late StefieK, since you were here participating in the "party" in April... Since then, I've increased my running to 6 miles, 5-6 times a week. As you read, the cactus paddles worked wonders... And now, it seems that the mucilage from ground flax seeds takes care of the problem too. However, I do believe that sudden increases in BP(30 points above normal, possibly from cortisol increases due to lack of sleep the night before, or spending too much time on the internet... or going a few days without eating fresh fruit or vegetables high in Vitamin C) causes stints of bleeding during/after the run... The only problem I'm having now is what seems like a slight twisted ankle... a tendonitis on the outside of the ankle probably from suponation combined with very uneven terrain caused by erotion in the park where I run.

I'm glad everything is going well with you...

Ross
 
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Oh no Ross, sorry to hear you're having tendon problems now. I always struggle with injuries that require stretching and physio as I'm not very disciplined and stop stretching as soon as I feel better!

Thanks so much for posting about the flax seeds and cactus paddles. I don't think the cactus paddles will be widely available in sunny scotland so I've ordered some seeds to see if I can try my hand at a bit of gardening Mexico style. I will def try the flax seeds as they're available, just need to find some reasonably priced.

Going to gradually start increasing my runs now so we'll see what happens!

Steph x
 
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Hi Stephie, I know what you mean about the stretching... I have much difficulty creating a stretching routine, even when I'm hurting. I tried running today. But, after 15 minutes, I decided to return to a brisk walk. The walking doesn't hurt. It did a few days ago...

As for growing Nopal Cactus in Scotland... I'm wondering if the winters would be too harsh and if the sun's rays are strong enough... It may be fine just buying flax seeds and grinding them in your kitchen. Plus, you will benefit greatly from the Omega 3 in Flax, especially if you're not eating enough cold water fish like Halibut, sardines, Tuna, small mackerel, salmon, trout or eel (I've just mentioned all of the fish high in Omega 3).

Anaemia may not be such a bad thing. I recently read something about decreased levels of iron protecting women from heart disease at least until menopause... The specialist who wrote on subject suggest maintaining iron levels on the low side for that reason... I'm not anaemic. But, my iron levels have been near borderline and seemingly have lowered over the past 7 weeks.

So how many kms or minutes are you running? What would you like to be running?

I have no desire to run a marathon... not near. But, I would like the opportunity to "float", fly or glide for a while... somewhere around an hour and a half... without injuring myself. But, I guess I did... Let's see when I get back to running comfortably.

Ross
 
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Prior to colectomy I ran several marathons and during training would often have some bleeding/mucous following a longer run (15- 20 miles) never on shorter runs. I am back to running (well,not sure it can actually be called 'running') but I now have blood following a six mile 'plod'. I wish there was some definitive information about whether or not this is actually damaging. When I had looked into it before, the running community people are saying it's normal for long or intense work outs but not for easier runs....still not sure what to do. (Have not been able to locate cactus paddles in my city)
 
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Hey J, whatcha doin' with that gun in your hand... The experts are only speaking for people with complete digestive tracts and not to the J-Pouchers... Regarding longer runs... I wonder if a J-Poucher could actually withstand a 3+ hour run regarding water, minerals and the need to go to the bathroom... I would use the information about bleeding and long runs for J-pouchers and shorter runs... like a 6 mile run instead of a half marathon etc...

As for cactus paddles... I believe that ground flax seeds offer sufficient amount of mucilage for preventing the bleeding. And you should be able to encounter flax seeds in any town in the U.S., Canada or mainstream Europe. I live in Mexico (from New York City originally). And I find flax seed wherever I am. However, you must grind your own flax seed in your kitchen. Don't buy it ground or it will be rancid... If you don't have a Vitamix Blender (recommended for J-Pouchers for breaking down a little more finely the insoluable fiber of cellulose in fruits and vegetables... along with use with nuts and seeds) or a Magic Bullet/Nutri Bullet, I suggest you purchase one... Cactus paddles are wonderful for health. But they don't give you Omega 3 fatty acids as do flax seeds (#1 vegetable source)...

Ross
 
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I have wondered about ever being able to run a full marathon (or even half)again.However reading the 'inspiration' posts (sorry I don't know how to quote posts)- Winnie did a triathlon; tommyb, an Ironman; and hfc completed the 50+ mile Comrades!! All j pouchers. There's hope for me yet! For now a 6 miler feels like a half marathon.
I'll give the flax a try and keep at it. If the bleeding continues, however, I may think twice about it.
 
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Just remember that it all has to do with quantities... I'm consuming between 2 and 5 tablespoons of ground flax seeds per day... It's easier to consume it in soups, since the mucilage in the flax causes a pasty thickening (absorbs around 10 times its weight in water)...

That's wonderful to hear about the J-Pouch athletes. I've reached a point in my life that I've GOTTA do it at all costs... "it"? Whatever it takes, be it running (injuries cause dampers), bicycling (if I could get a good bike like I had in NYC), rapid walking (not to confuse with speed walking, since I don't like the unnatural hip movement... hiking or stationary aerobics. I've got the research and information for the eating style. The question is the exercise that compliments the eating. As for understanding the J-Pouch and what the future holds with the J-Pouch... it seems that the experts really aren't experts. So, we've gotta be patient living greatly within our own very personal trial and error experiment...

But, speaking of Flax and trial and error... why are the J-Pouchers talking so much about over-the-counter drugs like Metamucil or whatever else thickens their stools if Flax seeds does the same thing but naturally, while supplying a great source of Omega 3, soluable fiber and Lignans?

Ross
 
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All of this makes me so much calmer. I have been training for a long bike ride and did two 30 mile rides over the weekend. I felt great until bedtime ~ when the bleeding started. Sounds like a combo of dehydration and perhaps the irritation from the saddle could be causing this. I have been using the ground flax with great success, but will also add some nopales to the regimen.
 
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I haven't been seeing any blood in well over a month now and haven't been eating nopales in a while; at least two months. The past few weeks I've been using ground flax seeds sporadically. Yet I've been running over 35 minutes 3-4 days per week during a period of very heavy work without bleeding. So, I'm thinking that the ground flax seeds healed whatever it was that caused the bleeding while running. Ground flax is much easier to ingest (2 tablespoons) in a large glass of lime or lemon water... I usually mix in 2 teaspoons of sugar..., although I maintain an extremely low-carb "diet"... Aside so many other issues, refined carbs (especially wheat products) increase greatly inflamation...
 
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