'Extraordinarily rare and unusual' bowel disorder killed marathon man, inquest told

Less severe ischemic colitis is treated with IV fluids, but the over 60s are most at risk

A fit and healthy 23-year-old man who died halfway through a marathon had been struck down by an “extraordinarily rare and unusual” disease, an inquest has heard.

Sam Harper Brighouse began having difficulties 16 miles into the Brighton Marathon on 14 April this year. Emergency teams rushed to help the stricken runner as he lay on the road, and administered cardiopulmonary resuscitation (CPR) because they thought he had collapsed due to respiratory problems.

In fact, the biology graduate, who was raising money for the Arms Around The Child charity, which helps Aids orphans, had suffered an extremely rare form of ischemic bowel disease described as “catastrophic and unsurvivable”.

Minor stomach cramps and diahorrea are common afflictions for marathon runners. Ischemic bowel disease, which occurs when blood flow is reduced to the large intestine and is most common in people aged over 60, can affect endurance runners, but they are unlikely to die from it.

Brighton and Hove coroner Veronica Hamilton-Deeley said the disease was “extraordinarily rare and unusual”.

Mark Taylor, a consultant pathologist at Brighton’s Royal Sussex County Hospital, confirmed that the condition is not usually fatal and said that Mr Harper Brighouse had been particularly unlucky.

“I think when someone collapses in a marathon, the most common thing to think is that they have had a heart attack,” he told the hearing. “The initial reaction would have been to do CPR and that was started rapidly. If he had been taken to hospital immediately, might it have made a difference? I don’t think so.”

Mr Taylor said: “I believe all his bowel was dead at that stage and even if [medical staff] thought of ischemic bowel, it wouldn’t have been any help at that stage. Unfortunately in Sam, it was catastrophic and unsurvivable.”

Cardiac problems among marathon runners are fairly prevalent. Taking part in the London Marathon in 2012, Claire Squires, 30, collapsed in front of Buckingham Palace on the final stretch of the race. An inquest later found that she had suffered a cardiac arrest after high levels of a the fat-burning stimulant that causes increased heart rate were found in her body.

Mr Harper Brighouse would likely have failed to notice abdominal pain because he would have thought it was related to his running, the inquest heard. “When it gets to that critical stage... how much of the bowel has died, [determines] whether the person can survive,” Mr Taylor said.

Ambulance staff also reported difficulties in reaching Mr Harper Brighouse through the crowds. Andrew Parker, a senior South East Coast Ambulance Service (Secamb) member who treated Mr Harper Brighouse, said he had difficulty in identifying the runner who lay on the road some distance from emergency teams.

Mr Parker said he ran 500 yards through the crowds trying to find Mr Harper Brighouse after the marshals were unable to tell him where he was. “In reality, it only took me minutes, as I did run as fast as I could, but obviously minutes in any cardiac incident are crucial,” he said.

It was unlikely the slight delay would have saved Mr Harper Brighouse’s life, he added. When he reached him the runner “had no heartbeat, no pulse and no breathing. From the small amount of history at the event, it was a sudden collapse. I don’t think he would have known anything about it.”

The inquest is due to conclude on Friday.

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