Trust your gut: Colonoscopy helps keep Fargo woman running

It was her sister that got Roberta Dubs into running.

"It was in 2008 or 2009, and I started with a basic 5K," recalls Dubs, who serves as a lead for reception staff at the Essentia Health-32nd Avenue Clinic. "My family then looked at me and asked, 'Why not train for the half?' and I was like, 'Don't push it.'

"But by the next fall, I was training for my first half," she admitted.

Dubs ran the Fargo Half Marathon in 2010 and her second half — the Garry Bjorklund Half Marathon in Duluth — in 2011.

Since then, she's continued to run 5Ks and another half-marathon.

"Running for me is a huge anxiety and depression reliever," explained Dubs who is part of an FSR (faster stronger runner) group. "My running group is like my second family. I love it." But what if you couldn't keep doing what you love?

Dubs faced this harsh reality this spring while training for another Fargo half.

By the end of March, she was experiencing something no runner wants — chronic, severe and often unpredictable — diarrhea.

"When you run, everything kind of shifts down naturally and you go to the bathroom anyway," she said. "But when I went, it kept being very watery and I knew something wasn't quite right. I was getting really concerned."

Dubs first turned to her sister, who had been previously diagnosed with a form of colitis — inflammation of the colon.

But as symptoms persisted and worsened, Dubs knew she had to do more.

"Nothing was working, and I was really starting to freak out," she explained as she debated canceling her race.

Dubs made an appointment with her primary care provider, Rachel Hare of the Essentia Health-South University Clinic, who quickly put in for an urgent colonoscopy with Dr. Kimberly Kolkhorst, a gastroenterologist at Essentia Health-Fargo.

Prior to the colonoscopy, Dubs recalls Dr. Kolkhorst looking at her and saying, "I want you to run that half. Just do as I tell you, and you'll be fine."

"It's understandable as to why Roberta had lost so much hope," explained Dr. Kolkhorst. "She was at the point where she couldn't do what she loves most, which is running."

While the tissue in Dubs' colon appeared normal, biopsies were taken during a colonoscopy for further examination. With pathology results, it was clear to Dr. Kolkhorst that Dubs' was suffering from a condition called microscopic colitis.

"Microscopic colitis is a type of inflammation, and it comes in two forms, collagenous and lymphocytic," explained Dr. Kolkhorst. You don't see it in imaging, and you may not see it during a colonoscopy. It requires biopsies and for tissue to be diagnosed under a microscope.

"Patients often present with persistent diarrhea and a lack of control, meaning accidents. For anybody that's a runner, we know that's one of your biggest fears."

Medications often induce this condition, with the two most common being NSAIDS, used for aches and pains, and proton pump inhibitors (PPI), used for symptoms like acid reflux.

Dr. Kolkhorst prescribed Dubs a gut-specific steroid called Budesonide which, over time, helped resolve her inflammation and symptoms.

With about a month to spare, Dubs was able to resume training and successfully crossed the finish line of two events during the Essentia Health Fargo Marathon week — the 5K on Friday, May 31, and the half-marathon on Saturday, June 1.

"It was a great feeling to pass that finish line," she said. "The runner's high was multiplied by 10 because I didn't know if I was going to do it."

Dubs added that Dr. Kolkhorst was on her mind at the time and she quickly took and sent a selfie with the caption, "Mission Accomplished! Thank you, Dr. Kolkhorst!"

"I can't thank her enough," emphasized Dubs. "Without her help, I wouldn't have been able to do it."

"When she sent me that photo, I was so proud of her," Dr. Kolkhorst said. "It's amazing because this is exactly what my goal was for her."

"I'm so proud of Roberta for sharing her story," she added. "People don't like to talk about their bowel movements, but guess what? We all have them, and once they start affecting your quality of life, it's so important to speak up and do something."

Dubs encourages others with similar symptoms to reach out to their primary care providers. She recalls bumping into a fellow runner shortly after the half and telling him about her situation.

"His eyes kind of lit up and he was like, 'You know what? I'm kind of experiencing that myself.' So, I told him to get it checked out," Dubs said.

"Knowledge is power," adds Dr. Kolkhorst. "It's important to spread the word about microscopic colitis so people know this condition exists and to be checked for it. You don't have to live in secrecy or fear. Talk about it and let's get this treated."