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Bob Murray, John Stofan, and Bob Sallis


This article summarizes a case of ischemic colitis suffered by a triathlete during an Ironman competition.


Exercise results in a significant reduction in splanchnic blood flow to help maintain cardiovascular function. When dehydration and heat stress accompany exercise, blood flow to the splanchnic vasculature is further reduced, increasing the risk of local ischemia and tissue injury.

Differential Diagnosis:

Ischemic colitis caused by dehydration and heat stress.


Right hemicolectomy involving a 16-cm segment of ischemic large intestine and appendectomy the day following the race.


This case study highlights one of the risks associated with dehydration during prolonged exercise in the heat. Of particular interest are practical interventions to reduce health and performance issues.


Poor hydration and nutrition practices during intense exercise can affect gut function, impair performance, and jeopardize health. Optimal intake of fluid, carbohydrate, and salt will enhance performance and reduce risk to health.

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Samuel N. Cheuvront and Robert W. Kenefick

body water deficits, or dehydration ( Sawka et al., 2007 ). A multitude of factors can affect SR and fluid availability, creating a combined challenge remedied only by personalized, circumstantial drinking strategies ( Garth & Burke, 2013 ; Hew-Butler et al., 2015 ; Lopez, 2012 ; Sawka et al., 2007

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Damir Zubac, Drazen Cular, and Uros Marusic

official weigh-in) to discourage aggressive weight-reduction despite the tragic events in combat sports, including death. 3 , 4 Recently, Reljic et al 5 proposed that adverse health-related issues in adolescent boxers originate from body-fluid manipulations, primarily achieved by acute dehydration, to

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Giannis Arnaoutis, Panagiotis Verginadis, Adam D. Seal, Ioannis Vogiatzis, Labros S. Sidossis, and Stavros A. Kavouras

Maintaining fluid homeostasis is vital for optimal athletic performance in both youth and adults. The loss of plasma volume (hypovolemia) concomitant with dehydration results in cardiovascular and thermoregulatory strain due to elevation of heart rate and decrease in cardiac output, ultimately

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Jason D. Vescovi and Greig Watson

accepted thresholds for dehydration and hypohydration, respectively. However, applying group-level data without knowing individual variation might not represent best practice. To date, only one study has examined the intraindividual variability of body mass and reported three consecutive days of morning

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Dale R. Wagner and James D. Cotter

composition. Thus, the purpose of this study was to determine the extent to which acute dehydration and hyperhydration affect subcutaneous fat thickness measurements obtained by A-mode ultrasound. Given that fat is essentially anhydrous, we hypothesized that hydration changes would have no significant effect

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Julian A. Owen, Matthew B. Fortes, Saeed Ur Rahman, Mahdi Jibani, Neil P. Walsh, and Samuel J. Oliver

No consensus currently exists on the best method to assess dehydration and prescribe fluid intake ( Armstrong, 2007 ; Cheuvront & Kenefick, 2014 ; Cotter, Thornton, Lee, & Laursen, 2014 ). This is in part because dehydration is a complex condition that manifests as different types. When fluid

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Paola Rodriguez-Giustiniani and Stuart D.R. Galloway

as drink composition and volume ( Shirreffs & Maughan, 2000 ), but it is also believed that hormonal changes associated with the menstrual cycle can influence fluid retention ( Fortney, 1996 ). Although fluid replacement after dehydration has been extensively studied in males, there have been few

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Douglas J. Casa, Samuel N. Cheuvront, Stuart D. Galloway, and Susan M. Shirreffs

extreme heat in which training and competition are likely to take place in Qatar, Tokyo, and other summer sporting venues of the future, the risks associated with dehydration could be amplified more than in previous years. This review focuses on the risks of dehydration and potential consequences to

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Devin G. McCarthy, Kate A. Wickham, Tyler F. Vermeulen, Danielle L. Nyman, Shane Ferth, Jamie M. Pereira, Dennis J. Larson, Jamie F. Burr, and Lawrence L. Spriet

∼70-minute practices. Thus, ice hockey goaltenders produce high sweat rates, reflecting a large physiological demand, and can lose >2% BM during practices. Becoming mildly dehydrated (1%–3% BM loss) during exercise increased heart rate (HR), core temperature ( T c ), and perceived fatigue. 6 – 9