Original Article

International Journal of Colorectal Disease

, Volume 27, Issue 11, pp 1485-1491

Preoperative exercise capacity in adult inflammatory bowel disease sufferers, determined by cardiopulmonary exercise testing

  • J. M. OttoAffiliated withThe Portex Unit, UCL Institute of Child Health Email author 
  • , A. F. O’DohertyAffiliated withThe Portex Unit, UCL Institute of Child Health
  • , P. J. HennisAffiliated withThe Portex Unit, UCL Institute of Child Health
  • , K. MitchellAffiliated withThe Portex Unit, UCL Institute of Child Health
  • , J. S. PateAffiliated withThe Portex Unit, UCL Institute of Child Health
  • , J. A. CooperAffiliated withCardiovascular Genetics, BHF Laboratories
  • , M. P. W. GrocottAffiliated withThe Portex Unit, UCL Institute of Child HealthIntegrative Physiology, Clinical and Experimental Sciences, University of Southampton
  • , H. E. MontgomeryAffiliated withUCL Institute for Sport, Exercise and Health

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Abstract

Background and aims

Aerobic exercise capacity appears impaired in children with inflammatory bowel disease (IBD). Whether this holds true in adults with IBD is not known. Using cardiopulmonary exercise testing (CPET), we assessed anaerobic threshold (AT) in such patients comparing data with reference values and other elective surgical patients. We also sought to confirm whether the presence of a fistula further reduced AT.

Methods

CPET was performed between November 2007 and December 2010 on patients awaiting abdominopelvic surgery. Gender-specific normal reference values were used for comparison. Unadjusted comparison between two groups was made using Mann–Whitney U test and by unpaired t test. Data were adjusted by analysis of covariance, using age and sex as covariates. Differences between patients’ observed values and reference values were tested using paired t tests.

Results

Four hundred and fourteen patients (234 male) were studied (mean ± SD age, 56.6 ± 16.4 years; weight, 74.2 ± 15.6 kg). Adjusted AT values in Crohn’s disease (CD) were lower than colorectal cancer (11.4 ± 3.4 vs 13.2 ± 3.5 ml.kg−1.min−1, p = 0.03) and for all other colorectal disease groups combined (12.6 ± 3.5 ml.kg−1.min−1, p = 0.03). AT of Ulcerative colitis (UC) and CD patients together were reduced compared to population reference values (p < 0.05).

Conclusion

After adjusting for age and sex, CD patients had a reduced AT compared to patients with colorectal cancer and other colorectal disease groups combined. The pathogenesis of this low AT remains to be defined and warrants further investigation.

Keywords

Inflammatory bowel disease Crohn’s disease Ulcerative colitis Cardiopulmonary exercise testing Surgery