Physical Exercise in Patients With Inflammatory Bowel Disease

Inflammatory bowel diseases [IBD] have an impact on the general patients’ well-being. Exercise training in patients with a chronic disease enhances their functional capacity and allows them to overcome the detrimental physiological effects of bed rest and previous sedentary living.1 The rate of regular exercise in patients with Crohn’s disease has been reported to range from 30% to 42%.2 Low-intensity activity of moderate duration is enough to elicit improvements in fitness, decrease stress, and ameliorate symptoms.2 Physical activity may induce the desirable effects of enhancing fitness and general well-being.3 In our centre, 18 patients with IBD underwent full cardiopulmonary exercise testing [CPET] using a treadmill. Participants were divided into two categories: 10 patients with inactive disease and eight patients with active disease. Participants in the two groups had similar characteristics in terms of age, gender, and body mass index [BMI]. The following pulmonary function tests were performed: spirometry, lung diffusion capacity, and full cardiopulmonary exercise test [CPET]. In addition, we measured maximum usage of oxygen [VO2max], maximum CO2 production [VCO2max], and total ventilation in anaerobic threshold [VEAT]. The analysis of our data showed that between the two groups with inactive and active IBD the spirometry and lung diffusion test results did not have statistically significant differences: (FEV1 [% predicted], 104.3 ± 2.3 vs 99.2 ± 9.1, FEV1/FVC [ratio], 83.8 ± 1.5 vs 80.0 ± 2.9, TLCO [% predicted], 105.0 ± 6.2 vs 118.2 ± 10.6, and KCO [% predicted], 99.4 ± 7.3 vs 112.4 ± 7.6, respectively, p = not significant). In addition, CPET results did not differ significantly between the above-mentioned groups (VO2max [l/min], 1.75 ± 0.20 vs 1.92 ± 0.26, VCO2max [l/min], 1.60 ± 0.20 vs 1.96 ± 0.35, and VEAT [l/min], 29.8 ± 4.1 vs 33.5 ± 3.2, respectively, p = not significant), yet remaining within normal values, suggesting that patients with inflammatory bowel disease have a competitive physical exercise potential. Regular mild exercise programmes can improve physical functioning and well-being of patients with IBD and reduce stress.4 Stress is known to orchestrate immunological and neuroendocrine changes that enhance vulnerability to auto-immune diseases, such as inflammatory bowel diseases. It has been reported that stress may play a role in the exacerbation of IBD.4 Stress has been significantly related to illness in patients with a low level of physical activity; thus physical activity has a beneficial effect on immune status and disease control.4 To date, employees with physically demanding jobs have lower prevalence of IBD.5 In conclusion, patients with IBD should not avoid exercise and they can be motivated to perform moderate exercise on a regular basis.