Patient experiences with the role of physical activity in inflammatory bowel disease

25 Aug 2021

By Carlijn R. Lamers, Nicole M. de Roos, Lola J. M. Koppelman, Maria T. E. Hopman & Ben J. M. Witteman 


Physical activity might have a protective role in the development of Crohn’s disease (CD) and ulcerative colitis (UC), and possibly also supports maintenance of remission and improves quality of life in patients with one of these inflammatory bowel diseases (IBD).

An increasing number of studies suggest that low to moderate intensity exercise might be beneficial for IBD patients by increasing health-related quality of life and reducing inflammation. Although the exact mechanism is unknown, modification of the gut microbiota and influence of physical activity on immunological processes have been proposed as possible routes of action.

Another way in which physical activity might be beneficial, is by reducing psychological stress.

In a longitudinal study in sixty UC patients in remission, researchers found that stressful events were associated with higher chances of relapse. Moreover, some studies suggest that physical activity might reduce fatigue levels in patients with IBD.

Despite the potential beneficial effects of exercise, a recent cross-sectional study showed that patients were significantly less physically active after their IBD diagnosis than before. It is not clear whether this was due to discomforts from their disease or to a certain fear that exercise would worsen their disease progression or symptoms.

In surveys, patients report to experience barriers to exercise due to conditions related to their IBD such as fatigue, joint pain and weakness, and fear for symptom exacerbation.

They also report complaints during physical activity such as an increased urgency and abdominal pain, making it hard to complete the exercise. However, interviews explicitly addressing patient experiences are lacking.

Since IBD patients experience less complaints during remission than during active disease, it is vital to sustain remission as long as possible.

Although medication is the predominant form of treatment, physical activity could be a complementary therapy that can be implemented easily in a patient’s daily routine. Consequently, it is valuable to understand the relation between physical activity and disease activity in IBD patients, and how this affects well-being.

Therefore, the aim of this study was to assess the association between physical activity and disease activity in a large group of IBD patients including both CD and UC patients, and to explain the nature of this association by interviews.


In conclusion, we found an inverse association between physical activity and disease activity in Crohn’s disease, but not in ulcerative colitis.

No causal relationship has been proven with this association, but interviews with IBD patients suggest that it is prudent to stimulate IBD patients to be more physically active, as they generally experience beneficial effects from physical activity.

When disease activity does not hinder IBD patients to be physically active, they experience an improved quality of life, reduced stress levels, less fatigue and a general feeling of fitness.

Intervention studies are needed to further investigate the effect of lifestyle factors like physical activity on the course of disease.

Original source here.