As a junior in college, Jenna Pettit, 24, was feeling exhausted and stressed out by her demanding coursework.
As a fitness instructor, she turned to exercise for stress relief.
It didn’t work. In fact, things got worse.
Pettit began experiencing concerning health symptoms. She could barely get out of bed, had uncontrollable diarrhea, lost 20 pounds, and spent a week in the hospital.
Pettit, who lives in Corona, California, eventually received a diagnosis of Crohn’s disease. After the diagnosis, she had to take a month off from her fitness classes.
Once she had a chance to process her diagnosis, she knew she had to get back to working out. But it wasn’t easy.
“It was hard getting back into my classes, because I just lost my muscle,” she says. “I lost that stamina.”
For Pettit and others living with gastrointestinal (GI) conditions — like ulcerative colitis, Crohn’s disease, irritable bowel syndrome (IBS), gastroparesis, or severe gastroesophageal reflux (GERD) — regular exercise can be a challenge.
But research has shown that staying fit leads to fewer symptoms in people with inflammatory bowel disease (IBD). IBD is an umbrella term that includes several GI tract disorders, like Crohn’s disease and ulcerative colitis.
Why exercise can be a challenge
Exercising regularly can be difficult for those with inflammatory diseases, especially when experiencing a flare. David Padua, MD, PhD, a gastroenterologist at UCLA and the director of the Padua Laboratory, which studies digestive diseases, says he regularly sees patients struggle to get exercise because of their symptoms.
“With things like ulcerative colitis, Crohn’s disease, and inflammatory bowel disease, the systemic inflammation can cause a lot of fatigue,” Padua says. “It can also cause anemia, and you can get GI bleeds as well with different types of IBD. This can all contribute to someone feeling really run down and not being able to exercise.”
But not all patients have the same experience. While some struggle with exercise, others play tennis, do jiujitsu, and even run marathons, says Shannon Chang, MD, a gastroenterologist at New York University’s Langone Medical Center. In the end, a person’s ability to exercise depends on their health and how much inflammation they currently have.
The benefits of exercise for GI conditions
Although someone living with a GI condition might find it difficult to exercise regularly, some research has shown that there’s a connection between higher levels of activity and fewer symptoms, especially with Crohn’s disease.
One study published in the journal Inflammatory Bowel Disease found that exercise is associated with a decreased risk of future flares in people with IBD in remission.
These results aren’t conclusive, though. “There is some suggestion that exercising and staying physically active with a moderate degree of activity may help with keeping the disease calm,” Chang says. Yet experts aren’t sure whether this is because people in remission are able to exercise more or because more exercise actually leads to fewer symptoms.
On the whole, experts agree that exercise is a good thing. “The data is a little bit all over the place, but generally what we have seen is that a moderate amount of exercise is actually really beneficial for someone with inflammatory bowel disease,” Padua says.
Pettit now works as a speech language pathology assistant and also teaches PiYo and INSANITY fitness classes. She says that exercise has always helped her manage her Crohn’s disease. She experiences fewer symptoms when she exercises regularly.
“I would definitely say that exercise helps keep me in remission,” Pettit says. “Even before I was diagnosed, I always noticed that my symptoms were less severe when I was working out.”
Benefits beyond remission
Physical activity has benefits that go beyond keeping GI diseases in remission.
1. Anti-inflammatory stress buster
Most healthcare practitioners believe that stress can induce flares in people with conditions like ulcerative colitis, Crohn’s disease, and GERD.
Doctors often hear that people with inflammatory GI diseases have flares during times of stress, Padua says. For example, they may experience a flare when switching jobs, moving, or having relationship issues.
“As clinicians, we hear these stories constantly,” Padua says. “As scientists, we don’t quite understand what that link is. But I really believe there is a link.”
Restorative practices like yoga can help improve the mind-body connection and lower stress. When stress is lowered, ideally inflammation will be, too.
In fact, one article published in BioMed Research International found that moderate exercise may help strengthen the immune response and improve psychological health in people with IBD. It may also help improve quality of life and reduce stress levels.
2. Better bone health
Another benefit of exercise in people with GI diseases is improved bone density, says Padua.
People with certain GI diseases don’t always have great bone health, since they’re often on long courses of steroids or have trouble absorbing vitamin D and calcium.
Aerobic exercise and strength training puts increased resistance on bones, which then need to get stronger to compensate, Padua explains. This improves bone density.
Exercising with a GI disease may:
- improve bone density
- reduce inflammation
- strengthen immunity
- prolong remission
- improve quality of life
- reduce stress
Best practices for exercising with a gastrointestinal condition
If you have a GI disease and have difficulty exercising, try taking these steps to get back into a safe and healthy exercise routine.
1. Talk to your medical provider
If you’re unsure what your body can handle, talk to a pro. “I always tell my patients that when they’re seeking physical activity — particularly someone who has a lot of GI issues — it’s always good to talk to their medical provider about how much they’re able to do,” Padua says.
2. Find the right balance
People can tend to have an all-or-nothing mindset with exercise and can even exercise to a degree that can be dangerous, Padua says.
On the other hand, you don’t want to treat yourself too delicately. Although you don’t want to overdo it, you don’t want to be so careful that you’re afraid to do anything, notes Lindsay Lombardi, a personal trainer in the Philadelphia area who works with clients who have GI issues. “You don’t have to treat yourself like a glass doll,” she says.
3. With strength training, opt for circuit-based exercise
If you’re interested in weight training, Lombardi recommends starting with circuits. This form of weightlifting can keep the heart rate up, but won’t be as intense as something like powerlifting.
Pettit recommends people ease into this type of exercise. Start out with something low-impact, like a bodyweight strength training class, she suggests.
4. For intervals, begin with low- to moderate-impact work
For those looking to improve their cardiovascular health, Lombardi suggests beginning with intervals. Start with low- to moderate-impact intervals. Work your way up if your body can tolerate it.
5. Incorporate restorative work into your routine
The mind-body connection plays a crucial role in reducing stress in people with inflammatory GI conditions, such as Crohn’s disease and ulcerative colitis.
“I would say the most important type of exercise for gut healing is the more restorative approach, like yoga and Pilates — stuff that really gives you more of that mind-body connection,” Lombardi says. “Not to mention that there are so many movements within those that are specifically good for your digestive tract.”
6. Listen to your body
Lombardi recommends people try out a variety of different exercises to find one that’s the best fit for them. Try out a spin class, for example. If that makes your symptoms worse, try something different, like barre. Or, if you’re doing yoga and find you’re able to tolerate it, increase your activity level and try something like power yoga or Pilates.
And when in doubt, switch up your routine. A self-proclaimed fitness enthusiast, Pettit never stops exercising when her Crohn’s flares up. Instead, she modifies her routine. “When I’m feeling fatigued or I’m in a flare-up or my joints hurt, I just have to modify,” she says.
Above all, remember that it doesn’t matter what type of exercise you’re doing, so long as you’re staying active. Whether it’s weight work or a gentle yoga routine, Lombardi says: “Keeping the body moving is so helpful to many of these gut issues.”
Jamie Friedlander is a freelance writer and editor with a passion for health. Her work has appeared in The Cut, Chicago Tribune, Racked, Business Insider, and Success Magazine. When she’s not writing, she can usually be found traveling, drinking copious amounts of green tea, or surfing Etsy. You can see more samples of her work on her website. Follow her on Twitter.