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Best & Worst Exercises For Crohn’s Disease

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A guide to the best and worst exercises for individuals with Crohn's disease to help improve overall well-being and quality of life.

Living with Crohn’s disease — a type of inflammatory bowel disease (IBD) — can be challenging. While most probably think about symptoms like abdominal pain, diarrhea, fatigue, and weight loss, 25-60% of adults with IBD also experience extraintestinal manifestations beyond the gastrointestinal tract, including osteoporosis, osteopenia, and muscle degeneration.

In this comprehensive guide, we’ll explore the best and worst exercises for individuals with Crohn's disease and the effects of physical exercise on IBD patients, helping you make informed choices to improve your overall well-being and quality of life. 

What is Crohn’s disease? 

Crohn’s disease, also known as regional enteritis or ileitis, is an inflammatory bowel disease (IBD). It inflames and irritates the digestive tract (the small and large intestines), leading to an overactive immune system with excess TNF-alpha which, in turn, causes the immune system to attack healthy cells in the gastrointestinal tract.

Benefits of exercise for people with Crohn’s disease

Helps prevent/reduce obesity

IBD patients who suffer from obesity may experience a complication in the clinical course of IBD, resulting in increased rates of hospitalization, the need for surgery sooner after diagnosis, and perianal complications. One of the potential benefits of exercise is that it helps in the treatment and prevention of obesity (alongside other diet interventions).

Helps prevent osteoporosis 

Patients with Crohn’s experience some degree of bone loss, in addition to a high risk of developing fractures. Also, about 50% of Crohn’s disease patients develop osteopenia (lower than normal bone density). For reference, people with normal bone density usually have a T-score of -1.0 SD or higher while those with osteopenia have a T-score of -1.0 SD to -2.5 SD. 

For about 13% of Crohn’s patients, osteopenia subsequently progresses to osteoporosis, which is a more severe bone density loss.

Exercise is associated with increased bone mineral density, especially for postmenopausal women and the elderly. It helps prevent osteoporosis later in life and may improve skeletal health for those with IBD.

Experts recommend that IBD patients walk for 20-30 minutes at 60% of their maximal heart rate three days per week, along with resistance training 2-3 times per week, in order to experience the impact of exercise on bone mineral density.

Aids in the treatment of ankylosing spondylitis

Exercise may also be beneficial for IBD-related conditions like ankylosing spondylitis, which is a type of inflammatory arthritis that primarily affects the spine but can also involve other joints. The treatment for ankylosing spondylitis is a combination of exercise and drug therapy. Randomized trials have proven the effectiveness of exercise therapy in improving the strength and flexibility of joints, especially in the spinal column. Exercise also helps with pain reduction in the joints.

Helps improve overall quality of life

In addition to improving specific disease symptoms of IBD, regular exercise can help reduce fatigue and improve overall health, sleep, quality of life, stress levels, body composition, and the perception of pain. In an evaluation of Crohn’s patients who had inactive or mildly active disease, researchers had participants walk three times a week. 58% reported improved life satisfaction.

Helps boost the immune system

Several studies suggest that moderate exercise can improve the immune system, although keep in mind that intense or prolonged exercise may have negative effects, especially during flare-ups.

Moderate exercise is thought to reduce inflammation by reducing visceral fat and the release of pro-inflammatory molecules while releasing substances like interleukin 6 (IL-6), which can help repair damaged intestinal tissue. This is particularly important since IBD is often treated with immune-suppressing drugs.

May decrease the risk of colon cancer 

Physical activity has been shown to help decrease the risk of colon cancer, something IBD patients are at higher risk of developing. 

3 types of exercises recommended for people with Crohn’s disease

Aerobic activity 

One safe, practical, and easy form of aerobic exercise is walking. It is the most common low to moderate-intensity exercise for patients with chronic disease. According to research, patients with Crohn’s disease can walk an average distance of 3.5 km (just over two miles) without exacerbation of their symptoms. 

Other low-impact aerobic activities include: 

  • Swimming
  • Stationary cycling 
  • Weight-bearing walking

Muscular resistance training

One of the most effective forms of exercise for preventing bone mineral loss and enhancing body composition in individuals with Crohn's disease is muscular resistance training, which involves exercises such as planks and lunges alongside equipment like elastic resistance bands or free weights. It’s crucial that these resistance exercises target the key muscle groups in the torso and legs. 

Flexibility exercises

Flexibility exercises are great for increasing the elasticity of the muscles, increasing muscle strength, and reducing joint pain.

One example is yoga, which can help boost the quality of life of IBD patients while reducing the level of disease activity, like inflammation. Tai chi is another great option.

One important thing to note when it comes to exercise is that dehydration is a special concern for Crohn’s patients, especially those who experience chronic diarrhea, making it especially important to sufficiently hydrate when exercising.

Exercises to avoid if you have Crohn’s disease

Research has not proven any long-term complications with exercise in patients with IBD. However, the safety of higher-intensity exercise in patients with severe Crohn’s or ulcerative colitis is unclear. Some research suggests that these types of exercise could contribute to intestinal inflammation, and abdominal pain.

Examples of high-intensity exercises to consider avoiding include:

  • Sprinting or interval running
  • Cycling sprints
  • Tabata training
  • Jump rope intervals
  • Battle ropes
  • Boxing or kickboxing
  • Box jumps
  • CrossFit 
  • Stair climbing
  • Circuit training
  • Burpees
  • Kettlebell swings
  • Mountain climbers
  • Jump squats

The bottom line

Overall, exercise has some beneficial effects like improved mood, better mental health, decreased stress, increased total body weight, and improved quality of life. There are also other benefits of exercise that are particularly important to IBD patients, like improved bone density and a decreased risk of colon cancer. It is important that IBD patients are guided in their exercise program by professionals to prevent exacerbation of disease activities. 

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