From the Guidelines
Physical exercise can be beneficial for people with ulcerative colitis when done appropriately, with moderate exercise potentially improving well-being and being safe in patients with quiescent or mildly active disease. Regular, moderate exercise may help reduce symptoms, improve quality of life, and potentially decrease inflammation in some patients with ulcerative colitis 1. Activities like walking, swimming, yoga, and cycling are generally well-tolerated and recommended for 30 minutes, 3-5 times per week. However, it's essential to start slowly and gradually increase intensity, especially during flare-ups when exercise should be gentler or possibly paused.
Key Considerations
- Exercise works by reducing stress (a known trigger for flares), improving immune function, enhancing mental health, and potentially modulating gut microbiota.
- During severe flares, high-intensity exercise should be avoided as it could worsen symptoms.
- Each person with ulcerative colitis should develop an individualized exercise plan in consultation with their healthcare provider, paying attention to how their body responds and adjusting accordingly.
- Staying hydrated and choosing convenient exercise times (not immediately after meals) can also help maximize benefits while minimizing discomfort.
Current Guidelines and Recommendations
The American Gastroenterological Association (AGA) has published guidelines on the management of mild-to-moderate ulcerative colitis, which emphasize the importance of a patient-centric approach and a holistic definition of ‘comprehensive disease control’ that goes beyond standard regulatory definitions of clinical remission 1. While these guidelines do not specifically address the role of exercise in ulcerative colitis, they highlight the need for a comprehensive approach to managing the disease, which may include lifestyle modifications such as regular physical activity.
Individualized Approach
It is crucial to note that the impact of physical exercise on ulcerative colitis may vary from person to person, and an individualized approach is necessary to determine the most appropriate exercise plan for each patient. This should involve consultation with a healthcare provider to develop a personalized plan that takes into account the patient's disease activity, overall health, and any potential contraindications to exercise. By prioritizing an individualized approach and incorporating moderate physical activity into their lifestyle, patients with ulcerative colitis may be able to improve their symptoms, quality of life, and overall well-being.
From the Research
Impact of Physical Exercise on Ulcerative Colitis (UC)
- The study 2 found that limited evidence suggests exercise may have beneficial, anti-inflammatory effects in patients with inflammatory bowel disease (IBD), which includes UC.
- In the study 2, 186 out of 227 patients with IBD (including UC) reported regular exercise, with 51% reporting moderate exercise intensity, 33% reporting light intensity, and 16% reporting vigorous intensity.
- However, 44% of patients reported that their IBD limited their exercise due to reasons such as fatigue, joint pain, and embarrassment 2.
- A more recent study 3 found that physical activity was inversely associated with disease activity, anxiety, depression, fatigue, and sleep disturbance, and positively associated with social satisfaction and quality of life in patients with UC.
- The study 3 also found that beneficial effects of physical activity were generally greater for strenuous PA intensity, suggesting that regular exercise may be a useful complementary treatment method for managing UC.
- Other studies 4, 5, 6 focused on treatment options and algorithms for UC, but did not specifically address the impact of physical exercise on the disease.