Introduction
Exercise is good for almost everyone, but it can be a challenge to stay fit when you have a chronic illness like Inflammatory Bowel Disease (IBD). This newsletter reviews the benefits of physical activity and includes tips about how to work with your disease instead of against it. If you have not yet made a New Year’s resolution, it’s not too late to make physical fitness your goal for 2011. For inspiration, read about Carrie Johnson, an Olympic kayaker who doesn’t let Crohn’s disease get in her way.
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Can physical activity really make a difference with my Inflammatory Bowel Disease?
Physical activity can decrease tension and stress, increase circulation and energy, induce feelings of well being, and aid digestion and body weight maintenance. What’s more, a recent review of seven studies suggests that, for people with IBD, physical activity is associated with a general decrease in disease activity. In several of the studies, the physical activity was as simple as low-intensity walking (for example, 30 minutes, three times a week).
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What if I don’t like to exercise?
Don’t think of it as “exercise,” think of it as being active, and then find an activity you like to do. You are more likely to make it a permanent part of your routine if you enjoy what you’re doing. Try walking, biking, dancing, or anything that gets you moving. Start slowly and remember that any amount of physical activity is better than none.
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What about when I’m having a flare?
During a flare, your body is working hard to fight IBD symptoms; pushing yourself will only make that job more difficult. Take it easy by trying gentle exercise like yoga and tai chi, and save more rigorous physical activity for between flares. Remember that you can decrease your risk of relapse by continuing to take your medication, even when you are feeling well.
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Curbing my fluid intake seems to help with diarrhea. Is that ok to do when I exercise?
It’s important to keep hydrated while exercising, so be sure to listen to your body and drink when you’re thirsty. A good rule of thumb is to drink 8 to 10 ounces just before exercising, and 4 to 6 ounces every 10 to 20 minutes during exercise. This will decrease your risk of dehydration, especially during a flare. Try electrolyte-based drinks, which can help you maintain a balance between dehydration and diarrhea. Since many sport drinks contain a lot of sugar, you may want to dilute them with water. Finally, remember that coffee, tea, and cola do not help as much with hydration, since they act as very mild diuretics.
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Is it my imagination, or is there something about my aerobics class that sends me running to the bathroom?
Some types of physical activity, like aerobics or running, can be hard on the digestive tract, due to repeated bouncing and decreased blood flow to your intestines. To get fit without battling bathroom breaks, try lower-impact activities that involve smoother motions, like skating, cycling, or cross-country skiing. If you have access to a pool, you also might find that exercising in water is a comfortable option.
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Is it ok to exercise if I’m taking immunosuppressive drugs?
Taking immunosuppressive drugs can make you more susceptible to other illnesses, so be careful to limit your exposure to germs. If you exercise at a gym, use hand wipes to clean shared equipment and remember to wash your hands immediately following your workout.
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I know that Inflammatory Bowel Disease increases my risk for osteoporosis. Can exercise help keep my bones strong?
Yes! Bone is living tissue that gets stronger with weight bearing exercise, like walking, dancing, and weight or resistance training. Strengthening your bones helps reduce your osteoporosis risk. Although there are currently no precise guidelines, even simple things can help, like walking more often and using the stairs instead of the elevator, or activities like gardening and housework. Also remember to get your vitamin D level checked.
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I know that Inflammatory Bowel Disease increases my risk for colon cancer. Can exercise help counter this?
Yes! A recent review of studies found that exercise can lower colon cancer risk by almost 25%. For example, one study found that the equivalent of walking briskly for 5 to 6 hours a week decreased colon cancer risk by 23%, when compared to walking only one-half hour a week. Researchers hypothesize that exercise decreases intestinal inflammation and has a positive effect on immune function. This is great news for everyone and especially for people with IBD, given their increased colon cancer risk.
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Conclusion
Regardless of the physical activity you choose, always check in with your physician before trying anything new. Then, once you get started, be sure to keep your doctor in the loop, especially if you notice any change in your IBD symptoms.
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Olympic Kayaker Carrie Johnson Talks about Exercise and Crohn’s Disease
According to Olympic kayaker Carrie Johnson, the two most challenging aspects of her sport are balance and strength. She clearly has ample strength and balance, both on the water and off. Diagnosed with Crohn’s disease in 2003 at age 19, she went on to win the Kayaking World Cup in 2007 and placed fifth in the world championships. She was the first U.S. kayaker to qualify for the 2008 Olympic Games and the only female U.S. kayaker to compete in the 1,500-meter race. At the 2004 Olympic Games in Athens, she finished tenth, the highest ever for a U.S. kayaker.
Johnson, now 25, gets her strength from a rigorous training regimen that includes paddling every morning and most afternoons, road biking, swimming and lifting weights. The balance she gets from listening to her body and making adjustments when necessary. She also knows that with a training regimen like hers, she must rest regularly in order to prevent flare-ups.
“For me, road biking is a good substitute for running,” explains Johnson. “There is less up-and-down movement. I used to run, but when I run I have to go to the bathroom frequently, which for a Crohn’s patient can be a very immediate thing.”
Johnson felt tired and weak and lost 20 pounds in just over a month before she was diagnosed in 2003. Then she had a flare-up again in 2008-2009 that prevented her from training and competing. “I spent a lot of time inside sitting on the couch during those periods,” she says, “because I couldn’t do anything else physically, which is one of the most frustrating things about this illness.”
She thrives on being active and says she feels better emotionally and physically when she exercises. “Exercise is a big stress reducer for me. And from a Crohn’s perspective, having a routine where I’m active makes me feel more regular,” she says. “It keeps things moving. But everyone is different.”
Johnson stresses that it’s important for everyone to discover what’s best for their body. “Worry about going to the bathroom can be very intimidating, and it was something I worried about a lot when I was first diagnosed.” She recommends making changes that reduce that kind of worry and stress, such as running on a treadmill with a bathroom nearby, for instance, instead of running outdoors. “It’s a good idea to test something out in a safe place to see how the activity affects you,” she says.
Johnson has also found that it’s helpful to think about and explore the options you have, instead of focusing only on the obstacles. “It’s important not to become too frustrated with the things you can’t do as well because of Crohn’s,” she says. “It helps me to think in broader terms and to remind myself that we all have things we can or can’t do, whether or not we have this disease.”
Johnson’s immediate goal is qualifying to race in the U.S. World Championships in August and then qualifying for the London Olympics. After that she hopes to study veterinary medicine, for which she is now taking prerequisite courses.
“I see myself competing until 2012, and then I’ll just have to take it one day at a time,” she says. Which sounds exactly like the helpful advice she has given herself and heeded every day since she was diagnosed seven years ago.
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