Exploring the gut-exercise link: A systematic review of gastrointestinal disorders in physical activity

Table 6 Summary of studies on physical exercise and inflammatory bowel disease

Ref.	Type of article	Summary of study characteristics	Outcome
Bilski et al[149]	Review	Reviewed relationships between exercise and IBD (Crohn’s disease and ulcerative colitis). Examined mesenteric fat’s role, adipokine regulation, and myokine-mediated anti-inflammatory effects	Exercise may protect against IBD onset and reduce inflammation through myokines. Further research needed to establish exercise regimens for IBD management
Khalili et al[150]	Prospective cohort study	Evaluated long term effect of exercise on the risk of developing IBD in 194711 women for 5 years	Physical activity was inversely associated with risk of Crohn’s disease but not of ulcerative colitis
Wang et al[151]	Meta-analysis of 7 studies	Examined the association between physical activity and IBD	High physical activity was associated with a significantly lower Crohn’s disease risk in Europeans only. No significant association between physical activity and the risk of ulcerative colitis
Engels et al[152]	Review	Examined benefits, barriers, and safety of exercise in IBD. Focused on immune response, bone mineral density, fatigue, and quality of life improvements in patients with mild-to-moderate IBD	Exercise is safe and may improve IBD symptoms, fatigue, and quality of life. Evidence on specific exercise recommendations remains limited
Holik et al[153]	Cross-sectional study	Studied the effect of daily physical activity on the activity of IBDs in therapy-free adult patients	Daily physical activity was associated with more IBDs remission persistence in patients not taking therapy
Legeret et al[154]	Case control study	Studied the effects of a single bout and chronic moderate-intensity exercise on IBD-related inflammatory markers and exercise capacity among children with IBD and healthy controls	While a single bout of exercise increases albumin, RBCs, and WBCs, long-term moderate-intensity exercise reduces inflammatory markers (ESR, CRP and thrombocytes) in children with IBD
Narula and Fedorak[155]	Review	Discussed potential of exercise to counter IBD-related complications (e.g., bone loss, psychological distress, and immune dysregulation). Identified gaps in consistent evidence for protective effects	Exercise improves psychological health, bone density, and stress management but must be tailored to patient-specific limitations and disease activity
Ordille and Phadtare[156]	Review	Analyzed intensity-specific exercise effects on IBD outcomes, including inflammation, immune modulation, and microbiome changes. Addressed safety of high-intensity exercise for IBD patients	Low-to-moderate exercise benefits IBD symptoms. High-intensity exercise may alter microbiome and immunity but requires individualized safety precautions

IBD: Inflammatory bowel disease; RBCs: Red blood cells; WBCs: White blood cells; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein.