Can a person participate in a mountain bike race during an Inflammatory Bowel Disease (IBD) flare?

From the Guidelines

Participating in a mountain bike race during an Inflammatory Bowel Disease (IBD) flare is strongly advised against due to the potential for exacerbating symptoms and delaying recovery. During a flare, the body's priority should be rest and management of the condition to reduce inflammation and alleviate symptoms such as diarrhea, abdominal pain, and fatigue. The physical stress of intense exercise, like that involved in a mountain bike race, can worsen these symptoms [ 1 ].

Key Considerations

• The risk of increased morbidity and potential for poorer wound healing, if surgery were required, highlights the importance of careful management of IBD flares [ 1 ].
• Pre-operative nutritional status is crucial in impacting postoperative morbidity and mortality, suggesting that nutritional health during an IBD flare is vital [ 1 ].
• The psychological impact of IBD, which may be exacerbated during a flare, also supports the need for careful and conservative management [ 1 ].

Management Recommendations

• Focus on managing the IBD flare with prescribed medications, such as corticosteroids, immunomodulators, biologics, or aminosalicylates, under the guidance of a gastroenterologist.
• Prioritize rest, hydration, and maintaining nutrition despite decreased appetite.
• Consider gentle activities like walking if feeling up to it, but avoid intense physical exertion.
• Once the flare subsides and symptoms improve, gradually reintroduce exercise, starting with low-intensity workouts before returning to mountain biking.

Consultation

Always consult with a healthcare provider before making decisions about exercise during an IBD flare, as they can provide personalized advice based on the specific condition severity and treatment plan [ 1 ].

From the Research

Participation in Mountain Bike Racing with Inflammatory Bowel Disease (IBD) Flare

• There is no direct evidence to suggest that a person can or cannot participate in a mountain bike race during an IBD flare 2, 3, 4, 5, 6.
• However, studies suggest that IBD can negatively impact physical activity and athletic performance, and that intestinal symptoms and extraintestinal manifestations of IBD can interfere with sports participation 6.
• Additionally, research indicates that IBD flares can be associated with increased risk of illness and injury, including gastrointestinal symptoms, which could be exacerbated by physical activity such as mountain biking 2, 3, 4.
• It is also worth noting that older age is a risk factor for inadequate energy intake during acute, severe IBD, which could impact athletic performance and increase the risk of relapse 4.
• Furthermore, the use of non-steroidal anti-inflammatory drugs (NSAIDs) is common among athletes, including mountain bikers, and could potentially interact with IBD treatment or exacerbate symptoms 5.

Considerations for Athletes with IBD

• Athletes with IBD may need to take precautions and consult with their healthcare provider before participating in physical activity, especially during a flare 6.
• Structured physical activity may be beneficial for IBD patients, but the optimal activity regimen is not well established and requires further research 6.
• Mountain biking, in particular, presents unique challenges, such as remote venues and isolated courses, which could impact access to medical care in the event of an emergency 2.