ABSTRACT
Introduction The broad diagnosis of chronic inflammatory bowel disease (CIBD) includes individuals with both ulcerative colitis (UC) and Crohn’s disease (CD). Together, these two conditions affect about 0.25% of the North American population, with a substantial direct economic cost (for example, an estimated $1.2 billion/year in Canada1). However, causes of the chronic inflammation are poorly understood; possibly, problems are related to inappropriately modulated immune responses.2 Ulcerative colitis is a localized inflammation of the intestines, but Crohn’s disease (CD) can also affect the mouth, oesophagus, stomach and anus.3 Genetic predisposing factors apparently differ for the two conditions.4 With appropriate management, the overall mortality for UC is close to population norms,5 but the global mortality from CIBD remains a substantial 0.8/100,000.6 Moreover, CIBD is a significant risk factor for the development of colonic cancer,7,8 reducing the age at which this type of neoplasm develops.9 The normal functioning of the intestines is seriously disrupted by the various manifestations of chronic inflammatory bowel disease, including UC and CD. Given a limited understanding of causation, much of the treatment of CIBD is empirical, and health professionals often fail to consider the potential benefits of augmenting what are typically low levels of habitual physical activity. This chapter thus begins by documenting current patterns of habitual physical activity in CIBD, and assesses the impact of limited activity upon functional capacity. It then examines the safety and practicality of programmes designed to correct loss of function, and notes the potential role of regular physical activity in the prevention and treatment of CIBD. It concludes with a brief commentary on the role of physical activity in the management of patients with coeliac disease.
