Rectocele: A potential cause of running-induced gastrointestinal bleeding

Running-induced gastrointestinal bleeding is a well-documented phenomenon for which past studies have proposed multiple potential etiologies, from ischemic colitis to a variety of mechanical factors caused by the repetitive impact of running. We present a novel case in which a female patient's chronic, running-induced hematochezia appears to have been linked to the presence of a rectocele. We hypothesize that the rectocele caused the anterior of the rectum to sag onto the posterior of the rectum, particularly under the added weight of stool in the rectocele, ultimately leading to contusions and ulcerations between the rectal walls from the high impact forces of running.