Being active with Crohn's or Colitis

• Exercising with Crohn’s or Colitis is safe and shouldn’t cause a flare-up.
• Being active can help reduce fatigue and improve mental wellbeing.
• Adults should try to do 150 minutes (two and a half hours) of moderate intensity exercise every week.
• You should avoid strenuous exercise for at least the first 4-6 weeks after an operation. After that build your activity levels up slowly.
• Belts and girdles can help support tummy muscles if exercising with a stoma.

It is not always easy to be physically active if you’re living with Crohn’s or Colitis. But being active is important for our physical and mental health.  It is safe to be physically active or to exercise with Crohn’s or Colitis. Current research suggests it does not cause flare-ups.

You might find it difficult to be active if your Crohn’s or Colitis is severe. Symptoms like tummy or joint pain, fatigue, or urgently needing to poo can get in the way. For some people, being active can trigger these symptoms. But most people with Crohn’s or Colitis say exercising makes them feel better. Some said they have more energy, better sleep and fewer gut symptoms.

Being active can improve mental wellbeing and quality of life, as well as reducing fatigue. Being active may also have positive effects on your condition, such as reducing the risk of a flare-up. Scientists believe regular exercise could help reduce inflammation in Crohn’s or Colitis. This has been seen in other long-term illnesses, but more research is needed to know for sure.

Most research on exercise has involved people in remission or with mildly active Crohn’s or Colitis, who were doing low or moderate intensity activities. Moderate intensity exercise is when your heart rate increases and you can talk, but not sing. Examples include brisk walking or cycling.

Higher intensity exercise is when you breathe harder and cannot say more than a few words without pausing for breath. Examples include running, aerobics or playing football. We do not know much about higher intensity exercise in people with Crohn’s or Colitis. But early research shows it can be safe and enjoyable.

There are no specific recommendations for exercising with Crohn’s or Colitis. It will probably depend on how active your condition is and your symptoms at the time.

If you’re not very active or your symptoms are making it difficult, try to build up your activity levels slowly. Walk to the shops instead of taking the car, use the stairs instead of the lift. Even sitting down less during the day can help. But be kind to yourself. If you’re not feeling up to it, don’t put pressure on yourself.

If you’re struggling to increase your physical activity, talk to your IBD team or GP. They may be able to suggest ideas to help you, based on your personal situation.

Having surgery for Crohn’s or Colitis can be a shock to your body, mentally and physically. You may find our pages on surgery for Crohn’s Disease and surgery for Ulcerative Colitis useful.

Following any surgery, you will be encouraged to move as much as you can. To begin with this may mean getting out of bed into a chair, followed by slowly walking. It is normal to feel your wound stretch when you stand up to walk. You should avoid any strenuous exercise for at least a few weeks after your surgery. This includes housework and lifting anything heavier than a full kettle for at least the first four to six weeks. This is so your wounds can heal properly. If you’ve had a stoma surgery, you may need to wait longer before lifting anything heavy. Ask your stoma nurse or surgical team for advice specific to you.

In the meantime, you can try gentle chair and standing exercises. Exercise should not cause pain, although it might be uncomfortable. Start slowly and increase your activity as you feel able. You should aim to be able to walk 30 minutes a day two to three months after your operation.

Having major abdominal surgery affects the muscles in the tummy. This in turn affects your core stability. Core stability is important for balance and good posture. Core stability exercises can help prevent tummy pain, backache and hernias. Hernias are bulges under the skin which happen if the gut pushes through gaps in muscles. Hernias are more likely to form after surgery.

The York and Scarborough Teaching Hospitals have produced a leaflet with some examples of core stability exercises you could try.

Swimming

Your surgical team, IBD team or GP can advise you when it is safe for you to go swimming. This may depend on the type of surgery you’ve had and what type of swimming you would like to do. There is some information on swimming after surgery on the NHS website which may be helpful.

Having a stoma should not stop you doing the exercise you enjoy. In fact, many people find they can go back to doing the things they used to before their operation. Once you have recovered from surgery, your stoma nurse might give you exercises to build up your tummy muscles and prevent hernias.

Build up the amount of exercise you do gradually. Do not rush or expect too much of yourself too quickly. For heavier activities, you could wear a belt or girdle to support your stoma and tummy muscles. Your stoma nurse can tell you when you can start playing contact sports again.

Read our information on living with a stoma for more support and information.

Swimming

Stoma bags are waterproof so you can go swimming if you want to.  You can get filter covers to stop the filters getting wet. Some people like to use a smaller stoma bag when swimming. If you want to cover up your stoma bag, you can buy covers in different colours and patterns. You can also get swimwear that is specially designed for people who have a stoma.

Colostomy UK have more information in their booklet: Active Ostomates- Sport and fitness after stoma surgery.

Some people like to take protein supplements, such as protein shakes, as part of their exercise routine. There is not much evidence on the effect of protein supplements in people with Crohn's or Colitis. Some research suggests whey protein may help with gut inflammation. But other evidence suggests a diet too high in protein can cause a flare-up. Protein supplements are highly processed and contain a lot of ingredients. Some of these might cause side effects if you take them for a long time. If you can, it’s better to get protein from food rather than supplements. This also helps you get other nutrients your body needs. Protein rich foods include eggs, cheese, meat, fish and pulses. If you choose to use protein supplements, check the ingredients. Different supplements contain different sources of protein, such as dairy versus plant based. Choose one that is suitable for you. For example, if dairy makes your symptoms worse avoid dairy based proteins, such as whey. Follow the instructions on the packet and mix the supplement with the right amount of water.

Read our Food resource for more information on how to eat well with Crohn’s or Colitis.

There are lots of successful sports personalities who have Crohn’s or Colitis. You can find out more about our sports ambassadors here.

Here are some tips from people living with Crohn’s or Colitis about exercising well with these conditions.

There are lots of different ways to be active. And it's important to remember that exercising does not have to be expensive. Going to your local park or following a YouTube video are great and free ways to build movement into your day. Your local leisure centre may have details of exercise classes or local sports clubs that you could join. To find sports facilities near you there is a national search tool for England on the NHS website. Choose ‘find other services’. Then select ‘sports and fitness services’ and enter your postcode.

Some councils have local schemes for people with long-term conditions. You may also find it useful to search online for accessible and disability sports in your local area. You can check what’s available at your local leisure centre, community centre or council here:

• Find your local Active Partnership (England only)
• Find your local council (GOV.UK)