Staying physically fit is a constant struggle for Stephanie Horgan, who, like millions of Americans with gastrointestinal disorders, has to plan her diet, her exercise routines, and her entire life around her condition.
"I'm really active now, doing kickboxing, jogging, [indoor cycling] at the gym, and eating whatever I want," says the 26-year-old Chicago resident, who was diagnosed with Crohn's disease at age 18 and had three surgeries within a year. "But you never know when you're going to have a flare-up. And when you have a flare, everything revolves around going to the bathroom and taking care of your body. Most social situations are out of the question."
Whenever Serena Ehrlich goes someplace new, she scouts out the location of the bathroom. That's because Ehrlich, 38, a Los Angeles-based salesperson for a commercial wire service, has ulcerative colitis. She developed the disease 12 years ago and has been in remission for the past three. Still, the old habit lingers. "Everyone who has ulcerative colitis will tell you that when you walk into a bookstore, a shop, or a restaurant, that's the one thing you want to know first. It's our rule of thumb."
Crohn's is one of two major types of inflammatory bowel disease (IBD). The other is ulcerative colitis (UC). Both cause abdominal pain, diarrhea, weight loss, lack of energy, and sudden bathroom urges that can lead to incontinence when sufferers sneeze, cough, laugh, or lift heavy objects.
Some of IBD's symptoms -- pain, bloating, cramping, and diarrhea -- are also common in people with irritable bowel syndrome (IBS), which is an entirely different condition, says Shanthi Sitaraman, MD, PhD, associate professor of digestive diseases at Emory University in Atlanta.
Diagnosis involves excluding IBD with a colonoscopy, she tells WebMD. "The GI tract has a nervous system of its own, just like the brain," she says. "The system perceives stress, makes bowels go faster or stand still.''
Exercise, too, can pose specific challenges for people with IBD or IBS, but the positives of getting in shape typically outweigh the negatives.
Most doctors who treat problems that cause incontinence say many people often don't feel like working out, but should try anyway to reduce stress, get their symptoms under control, and avoid diarrhea.
Cedric Bryant, PhD, chief science officer for the American Council on Exercise, says people with GI disorders like Crohn's disease, ulcerative colitis, and IBS need to exercise as much as they can because it can help them maintain a more normal body weight and aid digestion.
Exercise can also induce feelings of well-being, says Greg Sayuk, MD, a gastroenterologist at Washington University in St. Louis.
Scott Cole, a fitness instructor based in Palm Springs, Calif., agrees. He's found that yoga, tai chi, and breathing exercises have helped many of his clients.
"When you are sick or worried, you tend not to breathe fully, which kind of makes these things worse," he tells WebMD. "Some good mental energy works."