‘Running Through Ulcerative Colitis Literally Saved My Life’ – Runner’s World

For many runners with chronic illnesses, managing their condition in order to continue doing the sport they love can be a challenge. But the benefits they gain from it—a calmer mind, a reduction in stress, for instance—help motivate them to keep pushing forward.

But for 37-year-old Annabelle Winters, running through chronic illness hasn’t just given her a mental boost: It may have literally saved her life.

Winters is a lifelong runner. She started running in third grade, as part of an after-school club in her hometown in southern New Hampshire. While the team competition side of running never quite struck a chord, she has run continuously since age 10 because, in her words, “I just love doing it.”

Just like she has run for most of her life, Winters has also dealt with ulcerative colitis, a chronic inflammatory bowel disease, for most of her life, too—although she didn’t necessarily know it.

“I had celiac symptoms as a baby,” she says to Runner’s World. “In 1982, my parents were advised to remove gluten from my diet. They did, sort of, and my symptoms subsided.”

Winters lived fairly symptom-free for nearly 20 years before the disease really started to impinge on her life. At age 25, she started to be bothered by chronic gastrointestinal distress (i.e., the recurring, urgent need for a bathroom), along with cystic acne, and eczema.

Interestingly, it may be thanks to running that her disease stayed at bay for so long.

And that may have to do with how exercise—especially running—affects inflammation in your body, explains Brian P. Bosworth, M.D. chief of medicine at NYU Langone.

“Cells produce chemical messengers called cytokines that tell cells what to do. Certain messengers trigger the immune system to attack [causing inflammation], and others tell cells to turn off an attack,” he says. “With exercise, running in particular, it helps readjust the balance between pro-inflammation messengers and anti-inflammation messengers. So it can, in some people, help to modify or slow symptoms.”

Unfortunately, especially when she hit age 30, Winters would sometimes have symptoms—diarrhea, cramping, fatigue—so severe that she couldn’t even leave her apartment. Still, she continued to find ways to run.

And given the events of Wednesday, June 19, 2019 it’s a good thing she did.

On Tuesday, June 18, as part of her treatment for ulcerative colitis, Winters underwent an endoscopic mucosal resection (EMR), a routine procedure whereby she had a polyp (a precancerous growth) and a small section of her colon removed.

The surgery went smoothly, and she left with the happy result that her disease was in remission—something she and her three gastroenterologists had been working toward for the last five years. “Remission is an indication of how active the disease is,” she explains. “It’s basically how much your immune system is attacking your colon.” Remission is important because it decreases one of the biggest risks of having colitis: developing full-blown colon cancer.

Winters didn’t feel great the next day—sort of lightheaded and short of breath—but she also had bronchitis at the time, so she assumed all the cough and cold medicine she was taking was giving her “medicine head.” That evening, she started feeling some “gut action,” but, she wasn’t concerned: After most of her colonoscopies (she’s had six in the last seven years, including the one they did to perform the EMR), she’d experienced some diarrhea.

This time, though, she barely made it to the bathroom, and instead of diarrhea, she released a gush of blood.

“Like, imagine the worst road-trip-I’ve-been-holding-it-for-two-hours type of pee pressure,” she describes. “It was like that, but blood.”

When she called the after-hours number for her doctor’s office, the on-call doctor advised her to wait and see if the bleeding would stop on its own. While she estimated that she had passed about two cups of blood (which is a lot more than a normal post-op bleed), she was hopeful that her body would take care of it, so she agreed and went to bed.

A few hours later, she awoke with “the most urgent need for the toilet ever.” This time, when she got to the bathroom, the bleeding wouldn’t stop. She began feeling like she was going to pass out, but luckily her mother, who was sleeping in the living room of her apartment, heard her. Upon finding Winters bleeding in the bathroom, her mother woke up Winters’s husband and called 911.

Winters was taken to the ER at Advocate Illinois Masonic, where the doctors ultimately discovered that an ulcer had formed in her colon, near the site of the resectioning. Curiously, as biopsies taken during the EMR indicated, this did not happen because of any issue with the procedure, or even due to her ulcerative colitis.

“It’s basically like when you get a canker-sore on your tongue,” Winters describes. “Simply bad luck!”

The ulcer had nicked a blood vessel, causing an internal bleed.

In the hospital, the doctors used a microscopic metal clamp to stop the bleeding, but Winters could not go home yet, because she’d lost too much blood. And this is where the lifesaving properties of running came in.

Two things happen when you lose a lot of blood: First, with less liquid (blood) in the “pipes” (arteries and veins), the heart has to work harder to get the existing blood through the blood vessels and out to the rest of the body, so it starts beating faster. Second, when you lose blood, you lose hemoglobin, which is the red blood cell protein that transports oxygen. As Bosworth explains, without hemoglobin, your cells can’t get oxygen. Your heart can also become ischemic (not getting enough oxygen) and suffer a heart attack. If your brain is deprived of oxygen, it can lead to a stroke.

Ultimately, Winters’s cardiovascular fitness is what may have saved her. Runners tend to have slower resting heart rates than more sedentary people. Winters’s heart, for instance, beats an average of 48 times per minute, compared to the 60 to 100 bpm range of average adults.

That’s important: “With each normal beat of the heart, someone who has a lower resting heart rate is able to deliver more blood flow per squeeze of the heart,” says Bosworth. “And the heart expends energy every time it beats, so the more it beats, the more oxygen it needs.”

A heart beating 48 times per minute already needs less oxygen than a heart beating, say, 80 times per minute. So when blood loss forces it to start working harder, the 48 bpm heart won’t be put under the same amount of stress as the 80 bpm heart.

“Runners’ hearts are more economical,” sums up Bosworth. Ergo, less risk of a heart attack. And, because the heart isn’t working so hard to get oxygen to the brain, less risk of a stroke, too.

Winters’s body was able to withstand the massive blood loss without heart attack or stroke—or any lasting effects, once the doctors were able to stop the bleeding. In fact, she was released from the hospital that Friday, just 40 hours after having been admitted.

Nearly one month to the day later, Winters went for her first run. “My friend Cindy was my chaperone,” says Winters. “We went two miles. I felt tired but so good.”

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While she is recovering well from her harrowing internal bleed, her body is still replenishing its blood supply, and so she struggles with fatigue. Meanwhile, she has a whole battery of medicines and supplements she takes to keep her UC in remission, but she still experiences a lot of gut cramping, along with the occasional fever and skin reaction. “Being in remission doesn’t mean you’re symptom-free,” she explains.

Yet she still runs as much as her body will allow, and in fact is still preparing to run the Chicago Marathon this fall.

For Winters, the lifesaving effects of running go far beyond the physical. “In many ways, my ability to cope with a chronic disease comes from being a runner—learning to find peace while in a state of discomfort, and to always have x, y, and z contingency plan.”

Ultimately, she sees running as training for not just handling her disease, but also life. “We do hard things so that when hard things happen to us, we can handle it.”

Contributing Writer Allison Goldstein is a freelance writer and editor who is endlessly fascinated by the scientific “why” of things.