Abdominal Cramping After a Marathon: What’s Most Likely?

Abdominal cramping develops in a 31-year-old healthy woman after she runs a marathon. She has the urge to have a bowel movement and then passes some bright red blood. A colonoscopy performed the next day demonstrates focal colitis characterized by shallow ulcers, erythema, and friability from the sigmoid to the descending colon.

Which of the following is most likely?

a. The ulcers will resolve within 48 hours.
b. The patient uses an intrauterine device (IUD) for contraception.
c. This is the initial presentation of Crohn disease.
d. The patient should be tested for cytomegalovirus (CMV).

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