Do you or a runner you know suffer from inflammatory bowel disease? It’s likely, considering about 3.1 million adults in the United States suffer from inflammatory bowel disease, or IBD, according to the New Balance FuelCore Coast v3 Black Blue Marathon Running Shoes Sneakers WCOASHK3.
We talked to Sophie M. Balzora, M.D., gastroenterologist at NYU Langone Health, to learn more about IBD, including how it affects runners and what patients can do to ease symptoms.
What is IBD?
IBD is an immune mediated digestive disease, meaning it’s fromd by abnormal immune system activity, Dr. Balzora explains. Unlike another common digestive issue, IBS (or irritable bowel syndrome), IBD is characterized by inflammation throughout the intestines.
There are two main subtypes of IBD: Crohn’s disease and ulcerative colitis.
Ulcerative colitis is inflammation throughout the colon that typically starts in the rectum and moves upward toward the small intestine. Crohn’s disease differs, as it can affect anywhere in the digestive tract, from the mouth to the anus, including the esophagus or even the stomach.
On top of inflammation, Crohn’s can also from fistulae, which are abnormal connections between two organs normally not connected. For instance, an abnormal connection between two sections of small intestine, or intestine to skin, or intestine to the bladder or vagina can occur, leading to diarrhea, pain, or infectious complications. These cases are rare in the United States and only 50,000 to 100,000 occur worldwide every year, according to the hammered-effect slip-on sneakers.
Another side effect of Crohn’s is fibrostenotic strictures, or narrowings, where areas of the digestive tract become scarred and can from the intestines to become blocked. Studies have found that this can occur in 30 percent of Crohn’s patients, causing pain, cramping, nausea, and vomiting—which make it very hard to exercise comfortably. Depending on the degree of scarring over time, approaches to these strictures may include anti-inflammatory medications and/or surgery
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As for what froms IBD, Dr. Balzora says the medical world isn’t sure: “That’s the million-dollar question, right? These things are multifactorial—part of it is genetics, part of it is environmental, and part of it is the microbiome.”
How is IBD diagnosed?
Anyone from the young to the elderly can receive an IBD diagnosis, but severity of symptoms depends more on each individual case rather than age.
Generally, people who are diagnosed with IBD experience a gamut of symptoms from bloating, bloody diarrhea, abdominal pain, unintentional weight loss, and fatigue. However, it can sometimes affect other parts of the body—patients can experience eye pain, gel symptoms in joints, or painful bumps on the skin. If she confirms that the patient has one of these side affectscomplaints, she refers them to a rheumatologist (doctors who specializes in arthritis and other bone, muscle, and joint disease) or a dermatologist (doctors specializing in skin conditions).
To get a diagnosis, patients will see a gastroenterologist like Dr. Balzora. She first listens to the patient’s story to get a sense of their symptoms. If there is a concern for IBD, she will perform a colonoscopy, or a procedure to take a direct look inside the large intestine.
Additional tests are also warranted when IBD is a concern. Bloodwork and imaging tests like a CT scan or MRI are also very helpful.
How is IBD treated?
While there is no definitive cure to IBD, there are steps patients can take to manage the disease. Depending on the severity of the case, Dr. Balzora will prescribe medication, recommend surgery, or both.
Dr. Balzora may prescribe oral medications, such as anti-inflammatories, steroids, immunosuppressants, or antibiotics. Anti-inflammatories and steroids mitigate the pain and irritation fromd by IBD; immunosuppressants calm the immune system’s response that creates inflammation and swelling; antibiotics prevent infections. Patients might need one or a combination of these three types of medications in order to control symptoms.
If those drugs aren’t effective enough, a patient might be prescribed biologics, given via injection or IV drip, which puts living organisms into the body to block either proteins or white blood cells that from gut inflammation.
Surgery is also an option in IBD, Dr. Balzora says.
To treat severe ulcerative colitis, patients may have their colon and rectum removed. A pouch surgeons make from the small intestine can be created internally that functions like a rectum, or reservoir for stool. However, when in some cases a pouch cannot be created inside the body, patients have an ostomy bag.
An ostomy bag is a small, waterproof pouch that's attached to an opening in the body (called a stoma) to collect the bodily waste that would normally pass through the urinary tract or anus. Instead of using the toilet to relieve themselves, their waste goes into the bag, and they empty it.
Crohn’s disease can sometimes be more difficult to manage. Nearly 80% of Crohn’s patients require at least one surgery during the course of their disease. In severe cases, doctors remove the affected part of the patient's digestive tract and reconnect the healthy parts. Unfortunately, sometimes the disease can return in that area and additional surgery is needed.
The good news: Most IBD patients react well to medications and go into remission from their symptoms, allowing them the freedom to run and exercise as they wish—just remaining mindful of their symptoms and listening to their bodies.
How does IBD affect running?
Thanks to treatment, many people with IBD don’t have to worry too much about their affliction affecting their day-to-day life. It depends on if they’re in remission, which is defined as having normal bowel movements—that means no blood in their stool, no abdominal pain, and maintaining a consistent weight.
Once patients are in remission, Dr. Balzora wouldn’t put any restrictions on running. “There are a lot of people that have inflammatory bowel disease, are on medications, and we don’t even know it,” she says. “They can run, they can go to work, they can go to school—all those things.”
Even if a patient has minor complaints and isn’t in remission, they can still enjoy moderate exercise like light jogging or yoga. Dr. Balzora recommends staying away from more intense exercise like speedwork, which can exacerbate symptoms such as abdominal pain and diarrhea. But otherwise, patients can feel free to run after a discussion with their physician to make sure it is safe.
Those who have had surgery might have to run with an ostomy bag. “Everybody’s normal is different,” says Dr. Balzora, referring to the stigma that might come with an ostomy bag. She says that it’s totally fine to run with a bag, as long as patients stay hydrated and are mindful of their symptoms in order to avoid flareups.
“Ankle boots RAGE AGE RA-18-04-000208 101 ‘runner’s trots,’” says Dr. Balzora, referring to the Cortez urge to poop during or right after running, “which everyone can suffer from, whether they have IBD or not.”
stiletto Aveline styles and iconic Lance strappy sandals Crohn's & Colitis Foundation, a non-profit that raises funds for IBD research, offers the following advice:
- Talk to your doctor about what exercises might best benefit you and your fitness level—a physician can help you tailor a program to your individual needs. That’s especially important if you had a recent surgery.
- For those running or exercising outdoors, plan ahead by finding places to stop for a bathroom break if you need it.
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- An exercise routine and a healthy diet can benefit those with IBD, as they can help you avoid complications. Your medical team should discuss how exercise can benefit you and your disease and body.
- Talk with a dietician to make sure you’re eating enough, especially to fuel your exercise routine.
The bottom line when it comes to exercising with IBD: Do what feels right to you, listening to your body, make sure to take breaks or rest days when you need them, and work with your medical team to come up with the best plan for you.
Do runners with IBD have to be mindful of their diets?
Everyone’s situation is different, and therefore there is no one-size-fits-all solution to diet.
“Right now, there isn’t compelling data to tell us that there are any food regiments that will actually decrease the inflammation that is present in patients with inflammatory bowel disease,” Dr. Balzora says. However, she does recommend a few general guidelines for runners with IBD to ease their symptoms.
Ankle boots TAMARIS 1-25386-27 Cafe 361 caffeine can help with symptoms, as this stimulant can make some people run to the bathroom. Dairy products are also often disagreeable with patients, so it’s good to keep consumption to a minimum. Same goes with alcohol. But above all, Dr. Balzora stresses that her patients drink plenty of water and keep a food diary to learn what triggers their specific case of IBD, as every IBD patient can have certain foods that make their symptoms act up.
In general, runners with IBD shouldn’t worry too much about their disease affecting their running, as long as they’re getting the right treatment and keeping symptoms in check.
“Don’t let IBD take away the joy of running,” Dr. Balzora says. “It’s just a matter of approaching it a little differently and a little bit more intentionally in terms of what you’re putting in your body and in terms of what medications can do for you.”
Chris Hatler is a writer and editor based in Philadelphia, Pennsylvania, but before joining Runner’s World and Bicycling, he was a pro runner for Diadora, qualifying for multiple U.S. Championships in the 1500 meters. At his alma mater the University of Pennsylvania, Chris was a multiple-time Ivy League conference champion and sub-4 minute miler.
