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When suspected ‘runner’s colitis’ in a marathon runner turns out to be cancer−and in the end leads to a new personal best marathon time
  1. Peter Steiner
  1. Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  1. Correspondence to Dr Peter Steiner, Inselspital Universitatsspital Bern, Bern 3010, Switzerland; peter.steiner3012{at}

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In the autumn of 2016, I completed my second marathon. I was an ambitious 35-year-old athlete, participating year-round in activities that included running, road cycling, triathlon and alpine skiing. I was fit and well, and apart from pollen allergies I had not had any medical treatment. Approximately 3 hours after the marathon, I developed my first episode of bloody diarrhoea. As a doctor, I suspected this to be runner’s colitis but was not overly concerned. I knew that a proportion of marathon runners report gastrointestinal complaints.1

Persisting symptom led to a worrisome diagnosis

In the following days, my diarrhoea disappeared, but the blood in my stool persisted.

Without any worrisome thoughts, I first underwent a proctoscopy which showed small haemorrhoids. These were treated, but because I still had blood in my stool I had a sigmoidoscopy a few weeks later. At this investigation, the gastroenterologist showed me the tumour in my rectum, and I knew what this meant. I had a biopsy, and the information from this (and the requisite additional imaging) meant that I was needed radiochemotherapy and surgery.

Preoperative exercise training

Before the operation, I searched for additional support from sport and exercise medicine specialists as I knew this would help me through my therapy. I was …

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