Exploring obstacles to physical activity in inflammatory bowel disease: insights from a survey

BACKGROUND: Regular physical activity is recommended in Inflammatory Bowel Disease (IBD) and improves fatigue, psychological well-being and quality of life. However, many patients remain insufficiently active, and barriers to exercise are incompletely understood. This study aimed to explore patient-reported obstacles to physical activity and to assess awareness of and interest in Adapted Physical Activity (APA) programs for IBD. METHODS: A national cross-sectional survey was conducted from June to October 2021 among adults with IBD (≥18 years), recruited through a French patient association's social networks and 12 gastroenterology centers. The self-completed online questionnaire collected demographic and disease-related data, assessed physical activity using the International Physical Activity Questionnaire (IPAQ), and evaluated a pre-specified list of exercise barriers and awareness of APA. Disease activity was self-reported. RESULTS: Among 538 patients (71% female; mean age 37.7 ± 11.2 years; 55% Crohn's disease, 43% ulcerative colitis; 35% self-reported active disease), 79% engaged in moderate-to-vigorous and 21% in low activity by IPAQ. During flares, the main barriers were fatigue (76%), abdominal pain (64%), diarrhea (64%) and limited restroom access (38%). Persistent barriers included need for tailored advice (28%), lack of motivation (25%), joint pain (25%), social isolation (21%), financial constraints (20%) and fear of judgement or symptom worsening. Only 16% were aware of APA, whereas 60% expressed interest, particularly in supervised or group-based formats. CONCLUSIONS: IBD patients face symptom-related and psychosocial barriers to physical activity. Despite low awareness, strong interest in APA supports integrating structured, personalized exercise programs into routine IBD care.