Runners' diarrhea: Systematic evaluation of 1184 cases with meta-analysis

Nirmal S Mann, Sital Singh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: Gastrointestinal problems such as diarrhea and lower GI bleeding have been reported in long distance runners. We report such a case and results of systematic evaluation of 1184 such cases. Methods: A 39-year-old athletic woman complained of watery diarrhea (8-10 B.M./day) for one year. She had started running 15-20 miles per week about 1.5 years ago. Extensive work up for diarrhea and malabsorption was negative. She was advised to stop running. The diarrhea resolved completely in one month. A PubMed search without time or language barrier using the terms "diarrhea," "runners," "GI bleeding," and "anemia" was performed. Additional papers were manually added from reference list of key articles. Qualitative meta-analysis (QMA) was performed using the well established methods of qualitative research e.g. Diagramming, Theme Repetition Without Serious Contradiction, Theme Saturation and Investigator Reflexivity. Results: The search yielded 1184 cases of runner's diarrhea. Gender information was available in 1081/1184 (91.3%) of patients. There were 817/1081 (75.5%) men and 264/1081 (24.5%) women. The mean age of patients was 33.3 (range 16-67) years. The mean running distance was 26 (range 9-100) miles per week. The mean incidence of runners' diarrhea was 40% (range 10-80%). The possible mechanisms for this entity were evaluated and also possible therapeutic interventions. Conclusion: Runners' diarrhea occurs in 40% cases. It may interfere with athletic activities. Possible pathogenetic mechanisms and management of this problem were evaluated.

Original languageEnglish (US)
Pages (from-to)13-17
Number of pages5
JournalInternational Medical Journal
Issue number1
StatePublished - 2015


  • Diarrhea
  • Long distance runners'
  • Qualitative meta-analysis

ASJC Scopus subject areas

  • Medicine(all)


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