Diarrhea and Fecal Incontinence

Area of Science:

• Gastroenterology
• Sports Medicine
• Orthopedics

Background:

• Exercise-induced gastrointestinal symptoms like diarrhea and fecal incontinence can occur in athletes.
• While often benign, these symptoms can sometimes indicate serious underlying conditions.
• Identifying the root cause is crucial for effective management and athlete well-being.

Purpose of the Study:

• To report two distinct cases of endurance athletes presenting with severe gastrointestinal distress during strenuous exercise.
• To illustrate unusual presentations of lumbar spondylolisthesis and jejunal diverticulosis as causes of these symptoms.
• To emphasize the importance of thorough medical evaluation for exercise-related GI issues.

Main Methods:

• Case report of a runner with diarrhea and fecal incontinence.
• Case report of a cyclist with diarrhea and fecal incontinence.
• Diagnostic workup including physical examination and imaging (implied).
• Treatment and outcome assessment for both athletes.

Main Results:

• The runner's symptoms resolved upon avoidance of triggering activities, suggesting a link to lumbar spondylolisthesis.
• The cyclist's condition improved with a course of oral tetracycline, indicating jejunal diverticulosis.
• Both athletes experienced resolution of their debilitating gastrointestinal symptoms.

Conclusions:

• Lumbar spondylolisthesis and jejunal diverticulosis are rare but potential causes of exercise-induced diarrhea and fecal incontinence in athletes.
• Conservative management (activity modification) and targeted medical treatment (antibiotics) can be effective.
• Physicians should consider non-benign etiologies when evaluating athletes with persistent, strenuous exercise-related GI symptoms.