The Impact of Aerobic Exercise on Crohn’s and Colitis

Running circles on the beach, young female child circles her mother who is holding her welcoming arms out.

Today’s guest post comes from Dede Cummings.  You can find out more about Dede at the bottom of this post.  To learn how to submit your own guest post to Obesity Panacea, click here.

As a Crohn’s patient, who suffered in silence for over ten years, I found exercise to be the last thing I wanted to do, especially when I was experiencing the symptoms of a moderate case, such as diarrhea, vomiting, and fatigue. To me, during this time, exercise existed in the past tense. I had been quite a “jock” in high school, earning varsity letters in three sports. In college, I played two sports and recreational soccer my first year. When my symptoms started in the Spring of my first year, exercise (in my case, competitive sports) was the first thing I let go of.

I struggled with symptoms, becoming lethargic and moody, as my body quickly lost muscle tone and I dropped out of even social athletics. With the lack of a diagnosis, and my subsequent inactive lifestyle, I searched for answers, and went to a dermatologist, gynecologist, and my general practitioner over the years; I was put on oral prophylactics with the hope that the birth control pills would help the cramping that often coincided with my period, and told I had a “nervous condition” that was “due to stress.”

Fast forward to my life now, and you will see a healthy, middle-aged woman, who ran her first half marathon last year.

Physical ActivityWhy it’s important

Approximately 1.5 million people in the United States alone are afflicted with inflammatory bowel disease (IBD), a category of illnesses that includes Crohn’s disease and ulcerative colitis, and that number is steadily growing. According to the Crohn’s and Colitis Foundation of Canada,  “Canada has one of the highest incidences of IBD in the world. With an annual cost of $1.8 billion to individuals, their families and society at large, the burden of IBD is significant.” In 2008, there were over 200,000 cases of IBD reported in Canada, with over 9,000 new cases each year.

Exercise is one of the most important lifestyle practices to adopt when considering treatment options for Inflammatory Bowel Disease or Irritable Bowel Syndrome. No matter what your physical state is, there is always something you can do for exercise. It is always recommended to ask your GI doctor what is best for you in terms of levels of aerobic exercise—a post-surgical resection patient will have a different level of activity than a patient who has a case of IBD in remission. A marathon runner will have a different level of tolerance than a neophyte in the field.

In a 1998 pilot study titled “The effects of exercise on patients with Crohn’s disease,” from the University of Manitoba, 12 inactive patients with low-level cases of Crohn’s disease were monitored for 12 weeks in a thrice-weekly walking program to measure whether exercise had an effect on symptoms of Crohn’s disease.

At the end of the study, the baselines were compared (Inflammatory Bowel Disease Quality of Life Score, the Harvey and Bradshaw Simple Index, the Canadian Aerobic Fitness Test, and others) and the results showed no flare-ups during the term; in fact, there was improvement, both physical and psychological.

In an excellent summary entitled “Exercise and inflammatory bowel disease,” published in 2008 by the Canadian Journal of Gastroenterology, the authors examined current research to see if exercise helped counteract some IBD-specific symptoms. They found that exercise may in fact be beneficial to help prevent and alleviate symptoms of IBD — along with bone mineral density levels, overall stress management and psychological health improvement — but further research is still recommended.

How to get it (Exercise!)

Nowadays for me, exercise is just plain fun—as it should be!

My maxim for exercise is simple: do it a lot, and do it every day. Obviously, when you are not in remission, it is hard to contemplate; but starting slowly the way I did (walking to the mailbox was my first goal) is a way to integrate movement and exercise and the natural release of beneficial brain chemicals like serotonin.

A regular exercise routine can improve overall health, and may be particularly beneficial for people with IBD. Engaging in regular physical activity can reduce stress and maintain and improve bone strength. Some research has also shown that it relieves depression and boosts the body’s immune system response.

Another 2007 study from the Clinical Journal of Sports Medicine that looked at low-intensity walking, 3 times per week (in a 3-month study)  for 30 minutes, concluded that the 32 Crohn’s disease patients in the study had immediate benefits from the trial, in improving their quality of life. There were no exacerbations of symptoms, or flare-ups recording during the study.

If having IBD limits the amount and intensity of exercise you can undertake, keep in mind that even low-intensity activities, like taking a 30-minute walk three times a week highlighted in the 2007 study, can produce results. Talk to your doctor to determine an exercise program that works for you. If your symptoms make mobility difficult, find ways to be active at home.

One of my favorite activities that covers my daily dose of exercise, gets my heart rate up, and builds stamina and endurance is riding my bike to work whenever weather permits. I enjoy the satisfaction of saving gas money and feeling relaxed as I pedal the 5 miles in each morning (though going home is mostly those same 5 miles going uphill, which can be a bit daunting at the end of an eight hour workday).

Once you master the 30 minute, 3x-per-week walking, you may notice that symptoms may begin to decrease even while not in clinical remission. Cycling offers some diversity and cross-training, and weights can be added to an exercise routine, as long as symptoms do not worsen (I recommend IBD patients keep a daily log of what you did, what food was eaten, how many bowel movements, and how you feel in terms of stress and anxiety). Combining an eventual daily routine will help you build stamina, sleep better, and some people report that bloating and gas associated with Crohn’s and ulcerative colitis are diminished. Don’t forget that relaxation exercises, are very beneficial to reduce stress and tension that can impede recovery. A goal is to get your heart rate up, and break a sweat, but it is important not to overdue exercise, and balance activities to make it all fun and interesting. One great resource, as a way to reach your goal, is the Livestrong training guides for how to create a regular diet and exercise routine.

On weekends, a group of my friends sometimes plan to meet at 8:00 a.m. in a parking lot and we carpool to various hikes around the region, pulling back into the parking lot around noon. This type of exercise also offers a social component, which is another important part of maintaining good health—being active and social, or even getting out and doing all of the above with your children, thereby instilling in them a lifelong love of exercise and enjoyment that they will carry with them into adulthood.

Dede Cummings

About the author: Dede Cummings, author and Crohn’s patient, works as a writer, book designer, and literary agent. She lives in Vermont with her family. Her hobbies include hiking, yoga, running, reading, gardening and backcountry skiing. Her website can be found here.

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8 Responses to The Impact of Aerobic Exercise on Crohn’s and Colitis

  1. Pingback: My New Article for PLOS blog Obesity Panacea « Living With Crohn's & Colitis

  2. Elaine Kiely says:

    For years I lived a sedantry lifestyle due to the undiagnosed symptoms of Crohn’s- the effects were both physical and psychological- I became morbidly obese and felt like I had no control of my life or body. Being passed around from gynaecologists, to general surgeons to neurologists and even, most insultingly and depressingly, to a psychologist did not improve the psychological impact of the disease. Out of despair and being sick of feeling sick I decided that I had to try to take control of my body back…I began to exercise regularly (this was not easy, but by now I knew I had no choice) and drastically changed my diet. I began to eat regularly after years of avoiding food for as long as I could. Although I was obese I only ate once a day, usually at the end of the day when the consequences of eating could be dealt with a few feet away from my own bathroom, in privacy and with the least embarrassment. The first few months were difficult as the symptoms persisted with a vengeance, however, despite the seeming lack of physical improvements the psychological improvements were dramatic. I felt more in control of myself and my body; I felt like I was challenging myself and achieving something as my fitness improved; I felt like I was taking responsibility and taking my symptoms seriously even if no-one else was. Within 13-14 months I had lost nearly 12 stone and have now maintained a healthy weight for 5 years (no weight gain) and my fitness is progressing all the time. I’m fitter than I’ve ever been. I still get occasional flare ups and even when everything is good I still have pain and some symptoms – but I feel that usually I can manage these, I accept them and deal with them. They are more challenges to be met. The physical benefits have been important, but they pale in comparison to the psychological benefits. Feeling strong has helped me to get through the very bad flare ups that still occasionally occur- if I wasn’t improved psychologically I am not sure that I would have coped with these over the past 12 years. Feeling strong keeps me strong.

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  3. Dede says:

    Dear Elaine, what an inspiring story! I am so glad you wrote because I was hoping to inspire some people with IBD to write about their OWN experiences…. I sometimes wish Inhad more of a science background, so I could run my own study on this. I touched briefly on the psychological benefits of exercise, but I am so glad you pointed ut that steady exercise and the eventual weight loss made you mentally STRONGER, and better able to cope with the challenges of living with an incurable and sometimes chronic disease. I’ve been in clinical remission for almost seven years, and I, too, have occasional flare-ups, with pain, bloating, gas, and diarrhea. I sometimes freak out and even think that I will be heading for another obstruction and major surgery again, but then I try to calm down and I let my inner strength and resolve come forward….

    Daily exercise is really key, in so many ways. I am in touch with nature: sounds, sights, and smells. I do some stretching on my walks, and let my mind relax….Many people don’t realize how important it is to balance the brain and the gut. They almost work in tandem, with the majority of the body’s serotonin being made in the gut. So, your strong motivation is really exemplary, and I know you will inspire many other readers with your story!

    If you do have occasional pain associated with flares, try using a castor oil pack on your abdomen with a soaked woolen cloth with the oil, layered with clear plastic wrap (it gets oily), a towel, and then a heating lad. Lie down on a bed or couch for twenty minutes with the pack on your belly, and meditated….letting your mind drift, maybe even sleep. It is amazing how well it works!

    Are you taking a probiotic? Have you tried eliminating wheat from your diet?

    Good luck, and thanks again for your awesome comment! Happy trails, Dede

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