Like 300,000 other people living with an inflammatory bowel disease in the UK, writer Franchesca Flack has had an on-off relationship with exercise. She explains why, after a flare-up, she always comes back to movement as the thing to rebuild body and mind.
Christine* was diagnosed with Crohn’s disease aged 13, and it was only after her second bowel resection surgery in her late 20s that she felt well enough to begin her fitness journey. For Christine, exercise has become a vital part of her self-care routine, both for its mental and physical benefits. “I made sure I exercised consistently and realised that it was helping to relieve stress, which I believe in turn helped keep my disease under control,” she explains.
Her story isn’t unique. While exercise might be inexorably caught up in diet culture for many women, over the past decade, I’ve experienced how transformative movement can be for chronic illness.
For those of us who live with an inflammatory bowel disease (IBD) like Crohn’s disease or ulcerative colitis, we’ve been forced to discover ways – away from hospital appointments and medication – to help control our invisible illness. While these kinds of conditions vary from person to person, one of the biggest and most common flare-up triggers is stress.
Each day can vary. Christine recalls a day recently that started strong with a full-body workout and cycling 10k to work; by 5pm, her stomach began to cramp and she ended up in hospital with a bowel obstruction. While her medication helps to reduce inflammation and manage the condition, her symptoms can present themselves at any time, triggered by colds and other mundane events.
“At times, exercise is almost impossible,” she tells Stylist. “When I’m having a dark day with a flare or post-surgery, exercise looks more like getting out of bed and using the toilet – if I can make it that far. I have to be careful, and sometimes, that means not being able to exercise at all.”
Exercising to relieve physical symptoms and mood
My own IBD journey began aged 23 when I was diagnosed with Crohn’s disease and irritable bowel syndrome with constipation (IBS-C) after years of living with excruciating stomach cramps and bloating. My bowels are inflamed, slow and ‘sluggish’, according to the doctor who prodded and poked my abdomen when I’d failed to go to the toilet or pass wind for a week.
After my diagnosis and in search of the right medication, I forced myself to the gym and discovered that running helped to relieve my chronic constipation. As a result, my mood lifted almost immediately. Soon, I moved on to weight lifting to build my leg muscles after struggling to maintain a healthy weight for years.
A few years later in 2018, an emotionally distressing period caused a huge flare-up which landed me in hospital for a two-week stint. It didn’t take long to work out that it had been caused by my poor mental health, which only got worse the longer I languished in bed.
Living with IBD means navigating ups and downs
It took over a month after being discharged before I could move properly again. I started walking as a way to rejoin society and to help mend my bruised mind and body. Not long after, I ran a half marathon and climbed the Three Peaks despite chronic joint pain. Exercise brought me back to life mentally and physically.
Like so many IBD survivors, the risk of a flare-up is always just around the corner and that means having to be flexible in every part of life – work, socialising and fitness. I’ve had moments where I’ve been about to run a personal best before suddenly needing a loo desperately.
Christine says that the convenience of having a toilet close by is why she prefers home workouts: “It gives me the flexibility and convenience of being able to stop and rest, and more importantly, use the bathroom whenever I like without competition for limited facilities and ultimately without any embarrassment.”
Exercising when you can may help to deal with flare-ups
Dr Lindsay Bottoms (the irony isn’t lost on her), the research lead for sport, health and exercise at the University of Hertfordshire and a researcher for the incredible charity Crohn’s & Colitis UK tells Stylist: “There are lots of challenging situations about having IBD (around the toilet or anxiety). If you’re exercising, you start being able to deal with situations better.”
In 2019, during a study exploring exercising with Crohn’s disease, Dr Bottoms split people with the condition into three groups. One doing HIIT for 20 minutes, one cycling steady for half an hour and one group sticking to their usual activities.
By measuring the amount of inflammation with a blood test and stool samples, Dr Bottoms found that exercising didn’t make symptoms worse. In fact, it improved fitness and energy levels and reduced anxiety.
Dr Ioannis Koumoutos, a gastroenterology consultant specialising in inflammatory bowel diseases at Southend Hospital agrees that studies have shown that “low to moderate exercise is an important part of the treatment regime for patients with Crohn’s disease”.
He explains that “being physically active appears to reduce the severity of symptoms, improves mental health and wellbeing”. It’s also associated with long-term benefits like faster recovery from surgery, rebuilding weakened muscles and the prevention of calcium and protein loss from bones.
As of yet, there is no cure for IBD. It’s tough and frustrating feeling great one day then having to stop a workout halfway through to go back to bed the next. But I’ve slowly accepted how incredibly important it is to listen to my body and recognise when it’s telling me to rest.
As well as drinking enough water to keep my stools moving and medication to help maintain my condition, exercise – be it lifting weights, attending a pilates class or even going for a short walk – means moving my body any way that feels OK for me, and only me. It’s a lifeline for maintaining as good a mental and physical health as possible.
*Names may have been changed to protect privacy.
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