Safe and Effective Exercise

Recommendations for people with IBD

Light to moderate exercise is believed to be safe for people with Crohn's or colitis. 

In people with inactive or mildly active IBD that are sedentary, moderate walking or yoga can improve quality of life and stress levels, and typically does not worsen symptoms of IBD.

Experts recommend 30 minutes of moderate exercise at 60% of maximal heart rate, three to five days per week. They also recommend resistance training 2 to 3 times per week for its impact on bone mineral density. Some research studies suggest that this level of activity may decrease the risk of active disease.

Below are some safe and effective ways to get your body moving.

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Flexibility Exercises

Flexibility exercises help increase the elasticity of your muscles. They include stretching and range of motion exercises that improve the movement in your joints. Examples include stretching and yoga.

Findings from research studies show that yoga can improve quality of life and disease activity (inflammation) in people living with IBD. Currently, there is limited research evidence to determine if yoga improves symptoms associated with Crohn's or colitis.

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Strength exercises

Strength exercises help to increase muscle capacity, so that they can provide support and stability to your joints. Examples include lifting weights or using your body weight for exercises such as squats, push ups and crunches. 

Strength training during periods of remission (inactive disease) minimizes loss of muscle function in people with IBD (especially in the lower limbs). 

Kegel exercises (also referred to as pelvic floor muscle training) strengthen the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum. There are several factors that can weaken the pelvic floor muscles, such as severe constipation, being overweight, surgery, ageing, pregnancy and childbirth. 

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Endurance (aerobic) exercises

Walking is the most common low to moderate intensity exercise. In a study of patients with inactive or mildly active CD, 42% of patients reported a decrease in disease-related symptoms and 58% reported improved body image and life satisfaction. A later study found the exercise group reported a significant reduction in symptoms compared to the control group, who had a significant worsening of disease activity.

Treadmill training is shown to have anti-inflammatory effects on an inflamed colon. An hour on the treadmill was well-tolerated in IBD patients. Another study found running three times a week was well-tolerated in patients with mild to moderate IBD.

Swimming has also been shown to help reduce inflammation and relieve joint pain.

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Safety of high intensity exercise

No long-term complications have been associated with exercise in people with IBD. However, the safety of higher-intensity exercise in people with severe Crohn's or colitis is unclear.

Some research suggests that high levels of exercise could contribute to intestinal inflammation. In one study, exercising at a maximum of 60% oxygen consumption did not increase GI symptoms in Crohn's disease patients that were in remission.

Another study using animal models showed increased diarrhea and inflammatory markers with moderate-intensity forced treadmill running. In that same study with lower-intensity running, exercise was found to be protective against inflammation.

Decreased blood flow to the gastrointestinal system may occur in high-intensity exercises, which can increase gut motility in IBD patients. Gut motility is the stretching and contractions of the muscles in the GI tract, and it controls movement of food throughout the digestive tract. 

There is limited data to suggest if high-intensity endurance sports is safe people with Crohn's or colitis. A study of patients participating in triathlons, marathons and long distance bike races had no change in their stool that would indicate inflammation, and no change in their symptoms or disease activity scores. The 20% of patients who did have a change in their scores had them return to baseline within one week.

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Practical considerations and tips

Plan your exercises with practical considerations in mind, such as short group classes that allow for bathroom breaks when necessary, or pre-planned walking routes around your neighbourhood so you’re not too far from a friend or family member’s house if you need a break or bathroom (verus hiking in nature).

Download our GoHere application to find acessible washrooms near you and plan you trip. 

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Exercising during a flare-up

It’s a good idea to learn what your body is capable of in different stages of IBD: in remission, when experiencing low to mid-level symptoms, and in a full flare-up, that way you know what is “normal” to you. 

Those in remission or experiencing mild disease activity can safely perform low to moderate intensity exercises. Take advantage of these times to increase your fitness and try a new activity. Improvements you make during these good times will help you during a flare-up or in times of high stress. 

If you’re experiencing moderate to severe disease activity, you may want to stop exercising if you feel discomfort. In a flare-up, you can focus on low-impact activities like walking or light yoga. Focus on one muscle group at a time to build your strength. Rest when you need to and remember to listen to your body when it tells you to stop. 

Those recovering from surgery should speak with your healthcare provider to discuss your fitness needs and develop a plan to gradually build your strength. 

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