N009 Role of physical activity in inflammatory bowel disease management: a systematic review of literature
N. Cano Sanz*, M. Sierra, M. J. F. Gundín, P. Suarez
Hospital Universitario de León - CAULE, Gastroenterology - IBD unit, León, Spain
There is increasing evidence that exercise may improve symptoms in in individuals with inflammatory bowel disease (IBD). However, physiologic changes in inflammatory activity or patient limitations in fitness performance have not been well stablished in literature. We sought to review latest evidence about the role of physical activity on IBD management.
Systematic research was conducted in Medline®, using the combinations of key words exercise + IBD and physical activity + IBD. Articles published in English in the last 5 years were primarily selected for analysis. After abstract evaluation, articles with best evidence to answer ‘what is the impact of physical activity on the clinical course of IBD patients?’ were finally included in the review.
In total, 9 articles (5 reviews, 1 retrospective non-randomised comparative study, 2 prospective non-randomised comparative studies, and 1 randomised controlled trial) were included. Reduction of mesenteric white adipose tissue have shown to reduce adipocytokines and macrophage mediators involved in perpetuation inflammatory process, besides miokines released after exercise are suggested to be related to a disease activity reduction. Low-to-moderate intensity exercise has been shown to have positive effect on mood symptomatology (anxiety-depression) and fatigue. In addition, it improved health-related quality of life and the course of arthropaty because it favours better weight maintenance and counteracts osteoporosis. However, despite its benefits, between one-third and one-half of the patients report limitations in performing exercise because of joint pain, fatigue, and weakness, or embarrassment.
Although physical activity may benefit IBD patients in controlling physical and psychological symptomatology, exercise should be adapted to physical condition of each patient, including patient age and clinical course of the disease. Further investigation is needed to determine the role of physical activity in IBD management.