The Impact of Physical Activity on the Course of Inflammatory Bowel Diseases

Abstract

Inflammatory bowel diseases (IBD) including Crohn's disease (CD) and ulcerative colitis (UC), are chronic, immune-mediated conditions with increasing global prevalence. While the etiology of IBD is multifactorial—encompassing genetic, environmental, microbial, and immunological components—emerging evidence highlights the role of lifestyle factors, such as physical activity (PA), in modulating disease mechanisms and outcomes. This review explores the multifaceted impact of PA on IBD, focusing on gut microbiota composition, intestinal barrier integrity, and immune function. Moderate, regular exercise has been shown to beneficially influence gut microbial diversity, promote the production of anti-inflammatory metabolites, and support mucosal barrier function. Additionally, PA modulates systemic and intestinal immune responses, potentially reducing pro-inflammatory cytokine activity. In CD, visceral adiposity and adipokine dysregulation further complicate disease progression, suggesting a specific relevance of PA in this patient group. While observational and interventional studies indicate that PA may reduce anxiety and improve quality of life in IBD patients, the evidence regarding its effects on somatic symptoms and disease course remains inconclusive. Future randomized controlled trials are essential to establish standardized exercise protocols and clarify the therapeutic potential of PA in IBD management. Nonetheless, current data support PA as a safe, promising adjunct to conventional therapies, with potential benefits for both physical and psychological health in IBD patients.