Have a Digestive Condition? Exercise Smart

Exercising with a digestive condition is a catch 22: Physical activity speeds up the transit time to help with elimination. That said, it may make things worse.

Exercise is important—whether you have digestive issues or not, and not just for heart health and weight control. For instance, the more regular you are, the less you're at risk for colon cancer. But first, talk to your doctor. He or she may have suggestions geared to your specific condition.

Got the green light? Whether you suffer from Crohn's, IBS, or acid reflux, here are some smart tips for exercising with a digestive condition:

1. Go Low-Impact

"When the body is at rest, the majority of our blood is in the GI tract. But when you begin to exercise, the blood vessels in the gut constrict and the blood vessels going toward the active muscles dilate to increase blood flow to increase the metabolic rate," explains Molly Throdahl, ACSM-certified personal trainer, Ethos Fitness, Midland Park, NJ.

Throdahl says this could cause problems for people with digestive issues as they start to increase their intensity. She recommends that people with digestive problems, such as Crohn's disease, IBS, and even acid reflux, should keep the level low to moderate. As you get used to the intensity, you can ratchet it up.

2. Gauge Your Intensity

Keep the intensity on the lighter side—regardless of your cardio of choice.

  • Walking. It's easy, and you don't need any equipment. What's more, walking 30 minutes a day will boost your heart health and offset bone loss (people with IBS may be at higher risk for bone loss and osteoporosis because they're not absorbing calcium and vitamin D as well).
  • Running. Running is too jarring on the digestive tract, and it would probably cause you to work at a higher workload than your body can handle, says Throdahl. Instead, try to maintain equilibrium. "You don't want to feel out of breath. You want your breathing steady enough to have a conversation." If you can jog, and you're breathing is okay, then that's fine. But if you're breathing more heavily, and you can't talk and you're starting to get an upset stomach, that's an indication that you need to just walk for now. Over time, you can build up your stamina and endurance.
  • Cycling. Indoors or out, cycling is a great low-impact activity, but keep intensity light (spinning may be too intense). Use a heart rate monitor to gauge your intensity or rate of perceived exertion (RPE)—on a scale of one to ten, you want to be around five. RPE is a more subjective measure, but it's effective and easy. You want to work at a level where your heart rate is elevated, yet you're not gasping for breath.

3. Increase Warm-Up Time for Tougher Workouts

If you're an athlete, training can be a challenge. A long solid warm-up before you do the harder, more intense effort may help. Throdahl suggests spending 20 minutes to really warm up and get the bowel moving, and maybe eliminate, before you continue to your main workout; then cool down.

4. Watch Your Duration

As you push on for longer and longer periods, your blood volume is reduced due to dehydration. "You're losing fluid and that decreases blood flow even more to the digestive tract, which exacerbates problems," says Throdahl. Keep the time duration to a moderate 30 to 45 minutes.

5. Strategically Schedule Workouts

When and where you workout may make a difference:

  • Time of day. When planning your workouts, choose the time of day your bowels are the least active. This may be later in the morning—after you've been awake a few hours, after you've eaten breakfast, and after eliminating your bowels.
  • The route. Make sure you plan your route so that there is salvation (i.e., a porta potty or some place you can duck into if you have to go). Working out at the gym or on a treadmill at home will eliminate this problem.
  • The weather. Throdahl also warns of temperature extremes. Heat may exasperate symptoms and may bring on dehydration. Cold may be too hard on the body—especially if you have cardiovascular disease.

6. Smarter Strength Training

The same rule as cardio—keep it light to moderate. Throdahl recommends working at 70 percent of your one-repetition maximum and doing moderate loads, 10 reps, two to three sets, depending on your goals. In addition, your strength-training session should include eight to ten upper and lower body exercises.

7. Avoid Energy Drinks and Energy Bars

"High carb energy drinks, bars, and gels cause a lot of water to come into the GI tract to help dilute the solution. And that can cause more diarrhea and problems," says Throdahl. She also recommends steering clear of Gatorade and other more concentrated solution drinks.

8. Take Care During Flares

Be mindful. If you're going through a flare, you may want to take the day off.

Exercise caution: It takes food one to three days to really pass through the whole system. So if you eat something that wasn't so good for your system (ie, dairy or fatty, greasy foods) and then you exercise a day later, it may bring on a flare.

9. Eat Wisely

Avoid your trigger foods as well as fatty, greasy foods and high fiber foods (fiber is good, but before you exercise consuming high fiber may exasperate symptoms, according to Throdahl). Limit dairy and stay well hydrated. Make sure your meals are relatively small and if possible, eat at the same time each day. Sticking to a regular, predictable schedule may help minimize symptoms and flares.

10. Lessen the Stress

When your stress levels increase, anxiety gets worse. "The nervous system and its effect on stress hormones may cause an inflammatory response in the GI tract producing these issues. That's the hypothesis in the research right now," says Throdahl.

Yoga will help to reduce stress. Cardio exercise such as walking and cycling will help increase the immune system and decrease stress levels.

Don't let digestive woes derail your workout. "Finding what works for you will help increase your fitness—despite your digestive condition," says Throdahl.




Molly Throdahl, ACSM-certified personal trainer at Ethos Fitness in Midland Park, New Jersey.