EXERCISE IN IBD: GOOD NEWS (IF YOU EXERCISE ACTIVELY)

Several studies have shown that increased physical activity decreases the risk of developing Crohn's disease. Those exercising regularly, and especially those exercising daily, are at a decreased risk, according to a Swedish study (PG Persson, International J Epidemiology, 1993: pages 268-72). This was then shown again in a study of over 80,000 US women in the Nurses Health Study who also report on their exercise pattern, risk factors and health status every 2 to 4  years (H Khalili, British Medical Journal 2013; 16633. They did not find a significant reduction in ulcerative colitis, however.    

But what if you already have IBD? Can exercise help to put you into remission? A new study tried to answer that question PD Jones, Inflammatory Bowel Disease 2015; pages 1063-71. As part of a broad survey, these doctors from the University of North Carolina analyzed information from 1308 adults with Crohn's disease and 549 adults with ulcerative or indeterminate colitis who were in remission, and then they surveyed them 6 months later. 

What they found was that those with increased levels of exercise may decrease the risk of having active Crohn's disease by 32% or active colitis by 24%. That decreased risk because of exercise was seen even when they adjusted for age, gender, BMI (body mass index), smoking, the length of time that the person had their disease and whether they were on steroids or not. While it could be that healthier patients are able to do more exercise, it should be remembered that all of these patients were in remission when the study started.  

How Much Exercise is Enough?

The authors of this study used the Godin leisure-time activity index which is a weighted formula that gives a score for at least 15 minutes of vigorous, moderate or light exercise. To reach the level of increased activity it takes approximately   

• 3 weekly sessions of vigorous activity

or

• 6 weekly sessions of moderate activity

or

• 10 weekly sessions of light activity

Not so Hard, So Try ItThough it's uncertain how exercise specifically affects IBD status, the exercise seems safe and seems to have a real impact. Another study showed that those with Crohn's disease had significant improvement in their symptoms if they regularly followed a low intensity walking program (V Ng, Clinical J sports Medicine 2007; pages 384-8). In addition, the exercise will help to improve bone health.