Occult gastrointestinal bleeding in rugby player

BACKGROUND: Local ischemia and mechanical trauma to hollow abdominal organs are quoted as a cause of gastrointestinal (GI) bleeding during and after long distance running. There are no data on athletes from rugby and other contact sports where mechanical trauma of the abdomen is frequent. METHODS: Occult bleeding in the stool of Croatian national rugby team players has been investigated during and after qualification match with Italy for the World Cup 1999 on June 6th 1998 in Makarska, Croatia. One player with positive test was followed and examined in detail after the game. RESULTS: Among 11 Croatian players authors discovered one with a history of GI symptoms and one with conversion of negative to positive test for occult bleeding in stool after the match. The latter player had no GI symptoms or diseases, took no medications, played only 20 minutes in the match on forward position. Conversion has been found in the second stool sample after game (24 to 48 hours after game). The athlete was followed for 18 months. Persistent low values of hemoglobin, hematocrit and serum iron were revealed, as well as expressed hemorrhoids without signs of haemorrhage or inflammation. CONCLUSIONS: Lower incidence of GI bleeding among rugby players than among long distance runners minimize the importance of mechanical abdominal trauma in the etiology of GI bleeding during sports activity. Hemorrhoids are not quoted as a cause of GI bleeding after sport activity among athletes.