'I was 49kg and on the brink of collapse': The rider calling for greater awareness of Crohn's disease

"Eight years ago I all but stopped riding, basically because I didn’t want to get hit by a bus,” says Sam Gray, speaking to me from his home in south London. He describes having a “hard time” keeping alive his love of cycling after moving to the city in his early 20s. The problem was compounded by unexplained and worsening stomach problems. “After every meal, I’d go through a lot of pain and cramps,” he explains, “often having to spend a lot of time in the bathroom.” 

Gray finds it hard to explain now, but for almost a decade he put off seeking help. “I did the typical male thing of kidding myself, ‘it’s fine, I don’t need to see a doctor, I’ll leave it’.” Was it that he felt embarrassed about the nature of the symptoms? “Yes, and a lot of different things,” says the 33-year-old. “I felt somehow responsible for what I was going through, like I must be doing something wrong, eating the wrong things, living the wrong way.” 

After the UK went into lockdown in spring 2020, Gray’s job in film production became home-based, allowing him to ease back into cycling by spending lunch breaks on Zwift. Part of the motivation to get fit was that he was about to become a dad – his wife Chloe was soon to give birth to their first child. But Gray’s digestive system refused to follow the script. “Over the next few weeks, I was in pain more and more regularly, to the point where I was unable to pick up my baby daughter,” he explains. “I was in bed speaking to doctors remotely, with all kinds of different diagnoses being suggested.” 

It got so severe that, when his parents visited from the north to see their granddaughter for the first time, Gray lacked the strength to get up and spend time with them. He could no longer ignore that he was in serious trouble. “I was in too much pain. That night I finally snapped and rang 111 and arranged a call back from a doctor.” 

Within 24 hours he was in hospital – and sensing acute concern among the medics rushing around him. Only later did he learn that his vital signs had shown he was on the brink of collapse, while his body weight, then just 49kg, was judged perilously low for his 6ft 2in height. “It turned out the reason my pulse was so high was because I was fighting an infection,” explains Gray, “and that was because my small intestine had perforated – I had a hole in my intestine – caused by continuous inflammation from Crohn’s disease over many years.” Putting off treatment for so long had placed him in a life-threatening position. “The doctors said I was 24 hours from contracting sepsis, and that can kill you. I had waited until I literally couldn’t wait any longer.”

Crohn’s disease is a type of inflammatory bowel disease (IBD) that damages the digestive tract, often leading to scarring and, in cases like Gray’s, serious complications. It affects about one in 650 people in the UK, and though the underlying causes are not well understood, an abnormal immune response is often involved. Gray was in hospital for 12 days – unable to receive visitors because of lockdown rules – and then discharged on a liquid-only diet.

“Eventually I started to heal and get better,” says Gray, “and then I was fast-tracked on to a treatment called infliximab [a man-made antibody made from living cells], administered by intravenous infusion, as well as being put on a low-fibre diet.” Within six weeks he was feeling well enough to start cautiously cycling again and, boosted by advice from pro rider Cory Greenberg (see box), began to rebuild his fitness. “Exercise was definitely helping, and it felt like cycling was the right thing to guide my recovery,” adds Gray.

Further motivation was gained by treating himself to a new bike, a Ribble R872 Disc complete with dazzling ‘rhubarb and custard’ colour-scheme. Being seen is nowadays an important theme for Gray; cycling is no longer just about returning to fitness but also a means of raising awareness about health conditions ordinarily hidden from view. “I made a commitment to myself to talk about what happened to me,” says Gray, “and to help others talk about it too – Crohn’s is more common than most people realise.”

The ‘biologic’ treatment and modified diet have proved remarkably effective. “I am the healthiest I have been in my whole life,” he declares, “which seems a mad thing to say, but I now have to think about my health and take care of myself every single day.”

As well as sharing his cycling adventures on Instagram, Gray has teamed up with illustrator Kyle Platts to create an eye-catching jersey to raise money for the charities Crohn’s and Colitis UK and Mind. When we spoke, he was training for his first century ride, an accomplishment to mark one year since his diagnosis. “I know 100 miles isn’t the longest bike ride ever,” says Gray, “but for me, considering that one year ago I was unable even to get on a bike, it’s a huge milestone.”

This article was originally published in the 10 June 2021 print edition of Cycling Weekly. Subscribe online and get the magazine delivered direct to your door every week.