title: Can exercise affect the course of inflammatory bowel disease? Experimental and clinical evidence.
abstract: The inflammatory bowel disease (IBD) consisting of Crohn's disease (CD) and ulcerative colitis (UC) are defined as idiopathic, chronic and relapsing intestinal disorders occurring in genetically predisposed individuals exposed to environmental risk factors such as diet and microbiome changes. Since conventional drug therapy is expensive and not fully efficient, there is a need for alternative remedies that can improve the outcome in patients suffering from IBD. Whether exercise, which has been proposed as adjunct therapy in IBD, can be beneficial in patients with IBD remains an intriguing question. In this review, we provide an overview of the effects of exercise on human IBD and experimental colitis in animal models that mimic human disease, although the information on exercise in human IBD are sparse and poorly understood. Moderate exercise can exert a beneficial ameliorating effect on IBD and improve the healing of experimental animal colitis due to the activity of protective myokines such as irisin released from working skeletal muscles. CD patients with higher levels of exercise were significantly less likely to develop active disease at six months. Moreover, voluntary exercise has been shown to exert a positive effect on IBD patients' mood, weight maintenance and osteoporosis. On the other hand, depending on its intensity and duration, exercise can evoke transient mild systemic inflammation and enhances pro-inflammatory cytokine release, thereby exacerbating the gastrointestinal symptoms. We discuss recent advances in the mechanism of voluntary and strenuous exercise affecting the outcome of IBD in patients and experimental animal models.
authors.affiliation: Department of Ergonomics and Exercise Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Bilski
authors.affiliation: Department of Ergonomics and Exercise Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Mazur-Bialy
authors.affiliation: Gastroenterology and Hepatology Clinic, The University Hospital, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Bartosz
authors.initials: B
authors.lastname: Brzozowski
authors.affiliation: Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Magierowski
authors.affiliation: Gastroenterology and Hepatology Clinic, The University Hospital, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Janina
authors.initials: J
authors.lastname: Zahradnik-Bilska
authors.affiliation: Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Dagmara
authors.initials: D
authors.lastname: Wójcik
authors.affiliation: Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Magierowska
authors.affiliation: Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Kwiecien
authors.affiliation: Gastroenterology and Hepatology Clinic, The University Hospital, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mach
authors.affiliation: Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland. Electronic address: mpbrzozo@cyf-kr.edu.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Brzozowski
mesh_terms: D000818:Animals; D015444:Exercise; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*
keywords: Crohn's disease; Exercise; Inflammatory bowel disease; Myokines; Ulcerative colitis