Exercise in Individuals With Inflammatory Bowel Disease

Abstract

There is increasing evidence that exercise may improve symptoms in individuals with inflammatory bowel disease (IBD). This study aims to explore issues that clinicians may need to consider when giving advice on exercise to such individuals. Limited existing evidence suggests that low to moderate physical activity may improve symptoms without any adverse effects in individuals with IBD. This is largely supported by the findings of the current case series of "exercising" individuals with IBD who reported that low- to moderate-intensity exercise (most commonly walking) had a positive effect on their mood, fatigue, weight maintenance, and osteoporosis. Overexertion was reported as a potential problem. Scant advice regarding exercise had been given by their healthcare professionals according to participants. The current literature and findings of this small case series suggest that exercise is likely to be beneficial and safe for individuals with IBD. However, more research is required on which recommendations for exercise could be based.

Symptom management in inflammatory bowel disease

“…Treating fatigue with exercise may sound contradictory, at least to patients, however, in a small case series, patients who reported low-to moderate-intensity exercise (most commonly walking) had a positive effect on their mood, fatigue, weight maintenance, and osteoporosis [91]. Exercise has numerous benefits and this simple recommendation to our IBD patients can have a profound impact on the improvement of their fatigue as well as other aspects of their health.…”

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“…11 human studies [9,15,19,21,23,30,31,34,41,47,48] have looked at the influence of moderate exercise programmes upon disease activity in CIBD ( • ▶ Table 5). All 11 investigations have reported benefit in terms of reduced disease activity, although in some cases the experimental designs were not very satisfactory.…”

“…6 studies of varying quality [15,21,34,41,47,48] have all reported an increase in the quality of life in patients with IBD following an increase of habitual physical activity, commonly linked to functional gains.…”

“…13 studies ( • ▶ Table 6) provide data on the acceptance of exercise programmes [9,11,17,19,21,23,30,34,41,47,48,54,55]. The patient response compares quite favourably with that reported in other clinical conditions.…”

The effect of increasing physical activity and/or omega-3 supplementation on fatigue in inflammatory bowel disease

“…Given there are no evidence-based guidelines or recommendations regarding type, duration and intensity of exercise for IBD patients [30], we selected an individualised 'Treat-to-Target' strategy for the exercise advice intervention, aiming to initiate a ≥30% increase in PA levels [31]. The regime for the ω-3 FA intervention was comparable with the dose and frequency of regimes used in studies on the effect of ω-3 FA on IBD disease activity [1,32].…”