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Is Exercise Good or Bad for Ulcerative Colitis?

Exercise and ulcerative colitis

Ulcerative colitis can be a challenging disease to treat, and one question patients frequently ask is whether exercise is a good or bad way to manage this painful condition. The answer, according to new research, is yes, depending on the exercise.

How can exercise be both good and bad?

To answer this question, it helps to understand what ulcerative colitis is. Ulcerative colitis is one of two main types of inflammatory bowel disease, and unlike the other major type of IBD (Crohn disease), ulcerative colitis affects the large bowel (colon) and rectum only.

Symptoms of ulcerative colitis are often life-altering and can include rectal bleeding, frequent need to defecate, mucous discharge from the rectum, stomach cramps, severe diarrhea, fever, and distended abdomen. Stress is believed to aggravate symptoms. What if exercise could offer some relief?

At the University of Illinois, a research team evaluated the impact of aerobic exercise on mice with symptoms of colitis. They discovered that mice allowed to exercise freely for six weeks experienced fewer symptoms than did mice forced to exercise a few times per week for six weeks.

Here are a few other findings:

  • Mice forced to exercise also had a higher mortality rate than the mice that exercised freely.
  • Expression of pro-inflammatory genes in the colon of mice forced to exercise increased while expression decreased in mice who exercised freely
  • Forced exercise increased expression of an antibacterial signaling protein while voluntary exercise did not. This suggests forced aerobic exercise disrupts the fragile bacterial balance in the gut (colon)

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Several factors have a role in ulcerative colitis, including diet, genetics, psychological stress, and the bacterial environment in the gut. According to Jeffrey Woods, kinesiology and community health professor at the University of Illinois and one of the study’s authors, “very little is known about regularly performed moderately intense exercise, especially in those with inflammatory bowel diseases,” and so the information gathered from this study could prove helpful.

Other ways to help ulcerative colitis
Besides prescription medications (e.g., Simponi, sulfasalazine, corticosteroids, mesalamine), there are other ways to consider treating ulcerative colitis symptoms. One is the use of marijuana, which Italian researchers reported could be beneficial. Specifically, they noted that cannabidiol (a non-psychoactive ingredient in marijuana), “is a very promising compound” and a “potential candidate for the development of a new class of anti-IBD drugs.”

Numerous researchers have investigated the use of probiotics (beneficial bacteria) as a way to alleviate ulcerative colitis symptoms. A University of Bristol study looked at one strain in particular that is capable of withstanding the high iron levels typically seen in active IBD. More trials are needed before this treatment may be ready for market.

Another nondrug possibility is resveratrol, a phytonutrient found in red grapes and several other plants. Thus far, resveratrol has demonstrated its anti-inflammatory benefits in mouse models of IBD. Other natural approaches to relieving symptoms of ulcerative colitis include bilberries, and blueberries with a side of probiotics.

Results of this study seem to suggest aerobic exercise that is done in a nonstressful environment may be helpful while exercise that is forced may be detrimental. The authors concluded their work “supports a role for exercise in the adjunct treatment of ulcerative colitis in humans.”

Esposito G et al. Cannabidiol in inflammatory bowel disease: a brief overview. Phytotherapy Research 2012 July; doi:10.1002/ptr.4781
University of Illinois

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