Abstract
Background
Limited evidence suggests that exercise may have beneficial, anti-inflammatory effects in patients with inflammatory bowel disease (IBD).
Aims
The purpose of this study was to evaluate the prevalence of exercise in patients with IBD and the limitations they experience secondary to their disease.
Methods
Two hundred and fifty IBD patients were prospectively enrolled in this study at an academic medical center at the time of their outpatient visits between March and October 2013. Subjects were asked to complete a one-time survey that asks questions about medical and surgical history, exercise frequency and intensity, and the limitations and barriers they experience.
Results
Two hundred and twenty-seven patients (148 female patients) completed the survey. Crohn’s disease was present in 140 patients (61.5 %), while 87 had ulcerative colitis. Forty-one patients (16.4 %) never exercised, 82 patients (32.8 %) exercised 1–2 times per week, 59 (23.6 %) exercised 3–4 times per week, and 45 (18.0 %) exercised more than four times per week. Of the 186 who regularly exercise, 95 (51 %) reported moderate exercise intensity, 61 (33 %) reported light intensity, and 30 (16 %) reported vigorous intensity. Ninety-nine patients (44 %) reported that their IBD limited their exercise for reasons including fatigue (n = 81), joint pain (n = 37), embarrassment (n = 23), weakness (n = 21), and others.
Conclusions
Although they may benefit from exercise, IBD patients experience considerable barriers to regular exercise secondary to the relapsing and remitting nature of IBD. Larger studies are needed to determine the effects of exercise on disease symptomatology and activity.
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References
Bilski J, Brzozowski B, Mazur-Bialy A, Sliwowski Z, Brzozowski T. The role of physical exercise in inflammatory bowel disease. BioMed Res Int. 2014;2014:429031.
Ng V, Millard W, Lebrun C, Howard J. Exercise and Crohn’s disease: speculations on potential benefits. Can J Gastroenterol. 2006;20:657–660.
Pérez CA. Prescription of physical exercise in Crohn’s disease. J Crohns Colitis. 2009;3:225–231.
Narula N, Fedorak RN. Exercise and inflammatory bowel disease. Can J Gastroenterol. 2008;22:497–504.
Martin D. Physical activity benefits and risks on the gastrointestinal system. South Med J. 2011;104:831–837.
Loudon CP, Corroll V, Butcher J, Rawsthorne P, Bernstein CN. The effects of physical exercise on patients with Crohn’s disease. Am J Gastroenterol. 1999;94:697–703.
Ng V, Millard W, Lebrun C, Howard J. Low-intensity exercise improves quality of life in patients with Crohn’s disease. Clin J Sport Med. 2007;17:384–388.
Mack DE, Wilson PM, Gilmore JC, Gunnell KE. Leisure-time physical activity in Canadians living with Crohn disease and ulcerative colitis: population-based estimates. Gastroenterol Nurs. 2011;34:288–294.
Klare P, Nigg J, Nold J, et al. The impact of a ten-week physical exercise program on health-related quality of life in patients with inflammatory bowel disease: a prospective randomized controlled trial. Digestion. 2015;91:239–247.
Bilski J, Mazur-Bialy AI, Brzozowski B, et al. Moderate exercise training attenuates the severity of experimental rodent colitis: the importance of crosstalk between adipose tissue and skeletal muscles. Mediators Inflamm. 2015;2015:605071.
Nathan I, Norton C, Czuber-Dochan W, Forbes A. Exercise in individuals with inflammatory bowel disease. Gastroenterol Nurs. 2013;36:437–442.
Ball E. Exercise guidelines for patients with inflammatory bowel disease. Gastroenterol Nurs. 1998;21:108–111.
Woltmann ML, Foster C, Porcari JP, et al. Evidence that the talk test can be used to regulate exercise intensity. J Strength Cond Res Natl Strength Cond Assoc. 2014. doi:10.1519/JSC.0000000000000811.
Evertsz’ FB, Hoeks CCMQ, Nieuwkerk PT, et al. Development of the patient Harvey Bradshaw index and a comparison with a clinician-based Harvey Bradshaw index assessment of Crohn’s disease activity. J Clin Gastroenterol. 2013;47:850–856.
Vermeire S, Van Assche G, Rutgeerts P. C-reactive protein as a marker for inflammatory bowel disease. Inflamm Bowel Dis. 2004;10:661–665.
Konikoff MR, Denson LA. Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12:524–534.
Hwang C, Ross V, Mahadevan U. Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm Bowel Dis. 2012;18:1961–1981.
Craig CL, Russell SJ, Cameron C, Bauman A. Twenty-year trends in physical activity among Canadian adults. Can J Pub Health Rev Can Santé Publique. 2004;95:59–63.
Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005;45:1563–1569.
Wilund KR. Is the anti-inflammatory effect of regular exercise responsible for reduced cardiovascular disease? Clin Sci Lond Engl. 2007;112:543–555.
Packer N, Hoffman-Goetz L. Exercise training reduces inflammatory mediators in the intestinal tract of healthy older adult mice. Can J Aging Rev Can Vieil. 2012;31:161–171.
Packer N, Hoffman-Goetz L, Ward G. Does physical activity affect quality of life, disease symptoms and immune measures in patients with inflammatory bowel disease? A systematic review. J Sports Med Phys Fitness. 2010;50:1–18.
Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8:457–465.
Kredel LI, Batra A, Stroh T, et al. Adipokines from local fat cells shape the macrophage compartment of the creeping fat in Crohn’s disease. Gut. 2013;62:852–862.
Jung SH, Saxena A, Kaur K, et al. The role of adipose tissue-associated macrophages and T lymphocytes in the pathogenesis of inflammatory bowel disease. Cytokine. 2013;61:459–468.
Bilski J, Mazur-Bialy AI, Wierdak M, Brzozowski T. The impact of physical activity and nutrition on inflammatory bowel disease: the potential role of cross talk between adipose tissue and skeletal muscle. J Physiol Pharmacol. 2013;64:143–155.
Peters HP, De Vries WR, Vanberge-Henegouwen GP, Akkermans LM. Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract. Gut. 2001;48:435–439.
De Vries E, Soerjomataram I, Lemmens VEPP, et al. Lifestyle changes and reduction of colon cancer incidence in Europe: a scenario study of physical activity promotion and weight reduction. Eur J Cancer Oxf Engl. 2010;46:2605–2616.
Bernstein CN, Blanchard JF, Rawsthorne P, Yu N. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001;96:1116–1122.
Ali T, Lam D, Bronze MS, Humphrey MB. Osteoporosis in inflammatory bowel disease. Am J Med. 2009;122:599–604.
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Dr. Paul Christos was partially supported by the following Grant: Clinical Translational Science Center (CTSC) (UL1-TR000457-06). Dr. Ellen Scherl has received honoraria from GIHealth Foundation and Janssen for non-branded speaker’s bureau. Dr. Ellen Scherl is currently receiving grants/research support from Abbott (AbbVie), AstraZeneca, CCFA, Elan, Janssen Research & Development, Mesoblast (formerly Osiris Therapeutics), National Institute of Health (NIH), New York Crohn’s Foundation, Pfizer, Prometheus Laboratories, UCB, UCSF-CCA Clinical Research Alliance. Dr. Ellen Scherl is a consultant to AbbVie, Crohn’s and Colitis Foundation of America (CCFA), GIHealth Foundation, Janssen, Prometheus, Protagonist Therapeutics, Salix, Takeda Pharmaceuticals, and UCB. For the remaining authors, no conflicts of interest were declared.
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DeFilippis, E.M., Tabani, S., Warren, R.U. et al. Exercise and Self-Reported Limitations in Patients with Inflammatory Bowel Disease. Dig Dis Sci 61, 215–220 (2016). https://doi.org/10.1007/s10620-015-3832-4
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DOI: https://doi.org/10.1007/s10620-015-3832-4