Exercise Physiology and Physiotherapy for Crohn’s Disease and Ulcerative Colitis
Living with Inflammatory Bowel Disease (IBD), including Crohn's disease and ulcerative colitis, presents a unique set of challenges that extend beyond the digestive system. For many patients, IBD also impacts areas of daily life, including physical, mental and emotional well-being.
Exercise Physiology and Physiotherapy can play a crucial role in enhancing quality of life whether you have been recently diagnosed or have lived with Inflammatory Bowel Disease for a long time.
Working with a Physiotherapist or Exercise Physiologist can help manage pain and symptoms and support overall wellbeing, especially during flare-ups.
What is Inflammatory Bowel Disease?
The term inflammatory bowel disease covers chronic inflammatory conditions of the digestive system, including Crohn’s disease and ulcerative colitis.
Crohn’s disease causes chronic inflammation of the digestive tract and can affect both the small intestine and bowel, causing symptoms such as irritation, pain and diarrhoea.
Ulcerative colitis is also a chronic inflammatory condition that affects the inner lining of the large intestine, including the large bowel and rectum, causing tiny ulcers to form.
IBD can occur at any age but is most commonly diagnosed between the ages of 15-30 and presents differently between individuals. It can be unpredictable, causing debilitating symptoms. If left untreated, it can be life-threatening. IBD also significantly increases the risk of developing colorectal cancer.[1]
According to Crohn’s and Colitis Australia, there are over around 100,000 Australians living with inflammatory bowel disease (IBD) and this number is increasing each year.
Common symptoms of inflammatory bowel disease
Abdominal cramps and pain
Diarrhoea and urgency for bowel movements – sometimes with blood
Poor appetite and weight loss
Tiredness and fatigue
Anaemia from blood loss
Fever if in a flare.
Secondary conditions that can result from an IBD diagnosis
Low back pain – due to inflammation around the joints
Osteoporosis – due to poor absorption of key vitamins and mineral
Arthritis – due to inflammation at the joints
Liver damage – due to inflammation of bile ducts
Gall stones – due to poor absorption of nutrients
Depression – often due to the uncertainty and fear surrounding the condition.
How can an Exercise Physiologist and Physiotherapist help IBD patients?
Management of IBD often involves various health professionals and medications. Physiotherapy or Exercise Physiology can play an important complementary role in managing symptoms, supporting mental health and improving the well-being of patients with IBD.
An Exercise Physiologist can help you navigate a plan that will help you continue moving, manage your changing symptoms and support you to be exercise ready for the good days and the bad days. An Exercise Physiologist will look at your current symptoms and be able to create exercise programs that are tailored to your needs and goals whilst also taking into account any medications you are on or other health conditions you have.
A Physiotherapist can help address low back pain and other joint pain due to inflammation. A Physiotherapist can help to manage joint pain often associated with IBD through manual therapy techniques. A Physiotherapist can also be helpful during a flare, guiding patients with breathing techniques to manage pain.
There is growing evidence from clinical and experimental studies that suggest that stress can trigger IBD flare ups [2]. By engaging in exercise with an Exercise Physiologist or hands-on therapy with a Physiotherapist you have an increase in endorphin release (feel good hormone) which in return can help you manage any mental health issues and reduce risk of inflammation. Just talking to a health practitioner about symptoms and creating strategies to overcome and manage symptoms can ease that burden of stress.
The role of exercise in managing IBD
Exercise during a flare-up of IBD symptoms may be the last thing you want to do. Depending on the severity of your symptoms, exercise may simply not be possible.
However, the benefits of exercise are immense for improving your mental and cardiovascular health. Recent studies also show that exercise is a “natural way to boost the body’s immune response to reduce inflammation” [3] which makes it an important tool in your toolkit for managing IBD.
A combination of cardiovascular exercise (walking and cycling), resistance exercise (weights) and stretching is recommended. However, it’s important to work to your energy levels. Where energy and pain levels permit, we recommend following the ACSM (American College of Sports Medicine) guidelines for physical activity and exercise. These are based on the latest science and insights from health professionals.
Tips for exercising when you have IBD
When you’re feeling well, gradually add intensity to your exercise by increasing your weights, walking a little further or adding a hill to your ride.
If you’re in a flare, focus on low-impact exercises like walking and mobility exercises like Pilates and yoga.
If you exercise away from home, plan your workout around available public toilets or friends and family who live in the neighbourhood.
The pain and discomfort associated with IBD means you may tend to lay in a foetal position to ease discomfort. Ensure you’re stretching and moving regularly to prevent joint stiffness.
Know when your body has had enough and don’t overdo it.
Embody Movement can help
Embody Movement Exercise Physiologists and Physiotherapists have experience working with IBD patients.
If you need advice and guidance to help you manage a chronic condition or to help you get started after your diagnosis, contact us to book an appointment.
References
[1] NIH National Library of Medicine, Risk of Cancer in Patients with Inflammatory Bowel Diseases and Keys for Patient Management, published online 31 January 2023.
[2] NIH National Library of Medicine, Psychological stress in inflammatory bowel disease: Psychoneuroimmunological insights into bidirectional gut–brain communications, published online 2 October 2022.
[3] Ekaterina Pesheva, The Harvard Gazette, Research shows working out gets inflammation-fighting T cells moving, published online 2 November 2023.
Originally published 4 September 2021, revised and updated 30 January 2024.