9 Tips for Staying Fit With Crohn’s
Physical activity is important for everyone, but it has special benefits for people with Crohn’s disease. Research shows that when you exercise, your muscles release anti-inflammatory chemicals that reduce gastrointestinal (GI) symptoms. Activity also combats musculoskeletal complications of Crohn’s, including bone loss, joint pain, and posture issues, while easing stress, says Heidi Kosakowski, Ph.D., senior practice specialist with the American Physical Therapy Association in Alexandria, VA. These are a few Crohn’s-specific tips you’ll want to keep in mind for your fitness journey.
Pick Crohn’s-Friendly Moves You Actually Like
The best workout will depend on what you enjoy and what agrees with your body, says Ryan Hodgkinson, a certified personal trainer in Arlington, VA, who has Crohn’s. Hodgkinson favors Pilates; walking, yoga, and cycling are also great choices (low-impact exercises are gentler on the GI tract). Weight-bearing exercises are important for reducing the risk of osteoporosis and muscle loss, both potential complications of the disease, Kosakowski says. No matter your workout type, these tips will help you stay comfortable, confident, and fit.
Time Your Pre-Workout Meals
While you want to go into your workouts fueled and energized, finishing your pre-exercise meal about an hour beforehand reduces the likelihood of GI upset, says Vishal Gupta, M.D., a board-certified gastroenterologist with Gastroenterology of Greater Orlando in Florida. Plus, if you have an ostomy bag, spacing things out will allow you to empty your bag prior to your workout, says Hodgkinson, who has a permanent ileostomy. Pay attention to the timing that works based on your own digestive speed.
“People who have frequent diarrhea or have had their colon removed are more prone to dehydration,” Gupta says. “They will need to be aggressive about hydrating before and during their exercise.” Hodgkinson recommends drinking 17 to 20 ounces of water two hours before exercise and then seven to 10 ounces every 10 to 20 minutes during high-intensity exercise. Weighing yourself before and after your workouts can also be a helpful way for anyone to keep track of their fluids needs. For every pound you lose during your workouts, you need to drink about 16 to 24 ounces, he says.
Pack These Gym Bag Essentials
Stash a backup pair of underwear, or even pants, just in case. And if you have an ostomy, consider ostomy underwear and/or an ostomy belt to help secure the bag and reduce its visual footprint, suggests Erin Testerman, R.N., a certified wound ostomy continence nurse at Columbia University Irving Medical Center in New York City. She says a wicking compression shirt wicks away sweat from around the bag to prevent it from interfering with the flange. Ostomy shields can secure and protect the stoma, Hodgkinson says.
Identify Easy Bathroom Access
For some people, exercise—especially intense or high-impact exercise—can get things moving through your system. Whether you end up needing them or not, knowing where the bathrooms are—and keeping them relatively close—can help ease nerves. When exercising outside, pick routes that allow for any bathroom breaks you might need, recommends the Crohn’s & Colitis Foundation. “During group classes, set yourself up near the door and let the instructor know before class not to worry if you need to duck out,” Hodgkinson says.
Tap Into Mental Benefits, Too
When living with Crohn’s, the mental effects of exercise are just as important as the physical ones, explains Hodgkinson. Depression is a serious and unfortunately common complication of the disease, while stress and anxiety can contribute to flare-ups. Take advantage of exercise’s mental benefits by focusing on activities you enjoy and that make you feel capable rather than beaten down or frustrated, he recommends. You can also try mindfulness-based workouts such as yoga and Tai Chi.
Work With an Expert
Many people with Crohn’s think of the disease as a strictly GI issue. But it can have a large impact on posture, low-back pain, abdominal strength, and pelvic health, especially if you have severe symptoms or surgical scar tissue, Kosakowski says, so be sure to ask for help: “Even foundational exercises, such as pelvic tilts, may not be ideal for some people.” A physical therapist who specializes in working with people with inflammatory bowel disease can be a great asset in improving your quality of life.
Ease the Intensity During Flares
When symptoms spike, adjust your workout type and intensity to match your energy and ability levels. During these times, it can be helpful to think of “movement” rather than strict “exercise” as the goal, according to Kosakowski. Although exercise can have anti-inflammatory effects, intense or long workouts can exacerbate symptoms during flare-ups. Try slowing down your workouts, switching from running to walking, or performing gentle stretches and bodyweight movements. Integrating breathing exercises can help calm the nervous system and ease GI pain, Hodgkinson says. Try the Headspace app to find the breathing exercises and patterns that feel best to you.
Focus on the Long Game
Chances are, if you’ve had Crohn’s for a while, you know firsthand how difficult it can be to step back into your routine after a symptom flare. Don’t be too hard on yourself if your fitness level drops off. Hodgkinson says it’s normal to see fluctuations in your performance when you’re sidelined by chronic illness, but take heart. When you get back to the gym, listen to your body and focus on what you can do that day and celebrate the small victories. “Think about the long-game,” he says. “Your goal is well-being for life.”
- How Exercise Helps GI Symptoms: BioMed Research International. (2014.) “The Role of Physical Exercise in Inflammatory Bowel Disease.” hindawi.com/journals/bmri/2014/429031/
- The Importance of Bathroom Access: Crohn’s & Colitis Foundation. (n.d.) “Exercise.” crohnscolitisfoundation.org/campus-connection/navigating-college/exercise