She’s always been active, but when Megan Starshak began having gastrointestinal issues as a teenager, it put a serious cramp in her exercise routine.
“I was running in Florida on spring break in high school, and all of a sudden, I had to go to the bathroom -- badly,” says Starshak, who's now in her early 30s and works in marketing in Milwaukee.
“We found a bathroom, and by the end of the run, I had to go again... just as badly!” At first she thought she’d caught a bug, but the problem continued, along with fatigue and belly pain. Eventually her doctor diagnosed her with ulcerative colitis, a condition that causes inflammation in the digestive tract.
The worst part of Starshak’s situation? Her symptoms got worse when she was running. That’s not unusual for people who have GI disorders.
“Anyone who exercises and is using abdominal muscles puts pressure on the gastrointestinal tract -- including the stomach, small intestine, and large intestine -- and that can bring out symptoms,” says Keith J. Benkov, MD, a pediatric gastroenterologist at The Mount Sinai Hospital in New York.
4 Conditions That Exercise Affects
1. Crohn’s disease is an immune system condition that causes inflammation of the cell lining of the digestive tract. Symptoms include bleeding, diarrhea, belly pain, and not being able to eat.
2. Ulcerative colitis is similar, but it mostly affects the colon, not the entire digestive tract. “The disease is not as deep as Crohn’s but tends to cause more pain, diarrhea, and bleeding,” says Lisa Ganjhu, DO, a gastroenterologist and clinical associate professor of medicine at NYU Langone Medical Center.
3. Irritable bowel syndrome (IBS) brings on symptoms that can be "very similar to IBD [inflammatory bowel disease], but IBS never involves inflammation of the GI tract and usually doesn’t cause any blood in the stool,” Benkov says.
One way it can make activity tough is by making you have to go to the bathroom often. The GI tract moves in wave-like contractions. In people with IBS, sometimes those waves are faster, so you wind up with diarrhea, or slower, so you end up bloated and constipated, Ganjhu says.
4. Reflux won’t send you hurrying for a toilet, but it’s inconvenient when you work out, too. It happens when a leaky valve at the top of your stomach lets stomach acid wash back up into the esophagus (the tube that connects your throat to your stomach). It can cause heartburn and make it hard to swallow, and these symptoms can get worse during exercise, Ganjhu says.
Stick With It!
Although it can be tempting to throw in the towel and quit exercising if you have these conditions, you’re better off staying in the game.
“Exercise is actually very good for people with GI disorders, for a variety of reasons,” Ganjhu says.
For instance, losing extra weight, especially from around your belly, may lessen symptoms. Plus, you get endorphins, feel-good chemicals that your body makes. It also helps the healing process and curbs stress, which is often a trigger for symptoms.
To make sure your GI problems don’t get in the way of your fitness plan, follow these simple steps.
1. Speak up. “The first step is to be unafraid of opening up to others when it comes to your condition and how badly you are suffering from it,” says Evan Wood, 21, a New York University student with Crohn’s who has run three marathons and eight half marathons. “Ask for help.” Talk to your doctor and find other active people who have the same condition.
2. Stay hydrated. Crohn’s and UC raise your risk of being dehydrated and not having enough iron (a condition called anemia). If you’re exhausted, you might need to take a day off exercise. If you’re bleeding because of your condition, cut back on activity and tell your doctor.
3. Choose your workout wisely. You may need to change your plan for the day, depending on how you feel.
You can probably handle gentler types of exercise when your UC or Crohn’s is active, but skip harder workouts until your digestive system calms down, Benkov says.
“I wouldn’t recommend something like starting an intense regimen like CrossFit right after your diagnosis until your symptoms are controlled,” Ganjhu says.
Lower-impact options like Pilates, yoga, tai chi, and barre classes are a good way to go. Take it easy during movements that squeeze or put pressure on your belly, since those may irritate a GI disorder, Ganjhu says.
4. Be prepared. If you want to go on an outdoors run or ride, and you know you might get diarrhea, stash some toilet paper or wet wipes in your pocket. Also, map out your routine ahead of time, and try to make sure there are restrooms along it, Benkov suggests.
5. Check in with yourself. Try to notice how you’re feeling every 10 to 15 minutes during exercise. “Now I pay way closer attention to my body and what it needs, and I adjust as I need to,” Starshak says. “I still have bad days for sure. I do what I need to do when that happens, like walk instead of running.”
You might not need to change anything on many days. As long as your symptoms aren’t flaring, you can go for it, because exercise generally doesn’t cause a flare unless you become dehydrated or overdo it, Ganjhu says.
6. Have a plan B. “I always have a backup plan when exercising,” Starshak says. If she doesn’t feel up to her regular run, for example, she might ride a bike instead. “Putting your energy into finding a good alternative helps you get over the disappointment if you have to dial back your workout.”
7. Listen to your body. “If you’re exhausted, you need to be careful, probably drink more water, and possibly cut back on activity,” Ganjhu says. “And if you’re bleeding or experience any chest pain or dizziness, or if you just don’t feel up to your workout, something is wrong.” When that’s the case, stop, try to relax, and talk with your doctor.