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Status:Closed    Asked:Apr 11, 2013 - 12:57 PM

I have a client with crohns and wanted to know if there are any specific tips/precautions for exercising with this condition?

 
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Crohn’s disease belongs to a group of conditions known as inflammatory bowel diseases (IBD) and is named after Dr. Burrill B. Crohn, who first described the disease in 1932. Patients with this condition are believed to be genetically susceptible to contracting the disorder. Crohn’s disease is a chronic inflammatory condition that may affect any part of the gastrointestinal (GI) tract, from the mouth to the anus, but most commonly affects the end of the small intestine (the ileum) and the beginning of the large intestine (colon).


Symptoms related to inflammation of the GI tract include:


• Persistent diarrhea
• Rectal bleeding
• Urgent need to move bowels
• Abdominal cramps and pain
• Sensation of incomplete evacuation
• Constipation (can lead to bowel obstruction)
General symptoms may also include:
• Fever
• Loss of appetite
• Weight loss
• Fatigue
• Night sweats
• Loss of normal menstrual cycle


Furthermore, people with Crohn’s disease typically experience periods when the disease flares up and causes symptoms, followed by periods of remission with no symptoms. Although there is no cure for Crohn’s disease, there are strategies for treating the condition, which include taking anti-inflammation medication, such as prednisone; eating a nutrient-dense, balanced diet; and surgery involving bowel resection.


Exercise recommendations for individuals suffering from Crohn’s disease take into account the various symptoms and medication side effects. While there are no published exercise guidelines for Crohn’s disease, the scientific literature is replete with statements that patients with this condition should exercise but should first inform their clinician. Therefore, the first place to seek out specific recommendations is the client’s physician. He or she will be able provide exercise limitations and guidelines unique to the individual exerciser. Also, be aware that while consistent, regular physical activity is important for those with Crohn’s disease, it should be avoided during a flare up. Most individuals experiencing a painful flare up involving symptoms such as abdominal cramping, diarrhea, and fever will avoid exercising instinctively. Once symptoms subside, exercise should be encouraged with an approach that progressively increases intensity and duration to ease the person back into the swing of it.


Bone health is a big issue for people with Crohn’s disease because the inflammation process and the steroid medications used to treat it can combine to promote bone loss. Osteoporosis and a form of low-back arthritis called ankylosing spondylitis are common in Crohn’s disease patients. Exercise and drug therapy are common treatments for both of these bone disorders. As always, the client’s physician should provide specific exercise limitations and guidelines for patients with these medical conditions. However, the following general recommendations should be considered:


• For ankylosing spondylitis, core strengthening and trunk mobility movements are recommended. The National Ankylosing Spondylitis Society’s website is an excellent resource for these exercises.
• For osteoporosis, weightbearing activities, such as walking and stair climbing, along with resistance training are excellent choices. Visit this Fit Fact for more suggestions on exercises for the prevention of osteoporosis

If no other coexisting medical conditions are present with Crohn’s disease, the individual can participate in exercise as recommended for the general population with an emphasis on appropriate progression and careful self-evaluation of symptomatic flare ups.

 

Apr 11, 2013 - 12:59 PM

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