Inflammatory Bowel Disease: Symptoms, Causes, and Related Conditions
What is Inflammatory Bowel Disease?
Inflammatory bowel disease (IBD) is a group of chronic autoimmune-mediated conditions that cause persistent inflammation of the gastrointestinal tract. The two main forms are:
Crohn’s disease: can affect any part of the digestive tract from mouth to anus, most often the small intestine and colon. Inflammation is often patchy and can involve the full thickness of the bowel wall.
Ulcerative colitis (UC): affects only the colon and rectum, with continuous inflammation limited to the innermost lining.
IBD is different from irritable bowel syndrome (IBS). While IBS is a functional disorder, IBD involves true immune-driven inflammation and structural changes in the bowel.
Physiological Processes and Current Theories
IBD develops from a combination of genetic susceptibility, immune dysregulation, environmental triggers, and gut microbiome imbalance.
Immune dysregulation: T-cell activity (especially Th1 and Th17 responses) becomes overactive, releasing cytokines like TNF-α, IL-6, and IL-23, which sustain inflammation.
Barrier dysfunction: the intestinal lining becomes more permeable, allowing microbes and antigens to stimulate immune attack.
Microbiome imbalance: reduced microbial diversity and loss of protective bacterial species impair gut–immune regulation.
Genetics: mutations such as NOD2 and other risk alleles increase susceptibility, though they do not determine disease alone.
Environmental influences: smoking, stress, diet, and prior infections contribute to risk and flares.
Common Symptoms
Chronic diarrhoea, sometimes with blood or mucus
Abdominal pain and cramping
Unexplained weight loss
Fatigue and low energy
Urgency or frequency of bowel movements
Less Common Symptoms
Fever during flares
Nausea or loss of appetite
Perianal disease in Crohn’s (fistulas, abscesses)
Extraintestinal symptoms such as joint pain, skin rashes, or eye inflammation
Comorbidities and Extraintestinal Manifestations
IBD is not limited to the gut. Up to 40% of patients develop symptoms elsewhere in the body, including:
Musculoskeletal: inflammatory arthritis, axial spondyloarthritis, peripheral arthritis
Dermatological: erythema nodosum, pyoderma gangrenosum, psoriasis
Ophthalmological: uveitis, episcleritis
Hepatobiliary: primary sclerosing cholangitis (PSC)
Bone health: osteoporosis, partly from steroid use and malabsorption
Psychological: depression and anxiety are common due to disease unpredictability and impact on daily life
Diagnosis in 2025
Diagnosis is based on a combination of:
Endoscopy with biopsy to directly view and sample inflamed bowel tissue
Imaging such as MRI enterography or CT scans
Blood tests for inflammation markers (CRP, ESR) and anaemia
Stool tests for calprotectin, which reflects gut inflammation
Gastroenterologists are the specialists who diagnose and manage IBD.
Current State of Knowledge
As of 2025, IBD is recognised as a systemic immune-mediated condition influenced by both genetics and environment. Key advances include:
Biologic therapies (anti-TNF, anti-IL-12/23, integrin inhibitors) and JAK inhibitors, which have transformed outcomes.
Microbiome research, with ongoing trials into probiotics, prebiotics, and faecal microbiota transplant.
Lifestyle and stress research, highlighting the role of sleep, stress regulation, and exercise in reducing flare frequency.
Recognition of comorbidities, especially musculoskeletal pain, arthritis, and fatigue, as central to patient well-being.
If you are living with inflammatory bowel disease in Cork and want to learn about rehabilitation and management beyond medication, read more about IBD treatment and rehabilitation here.
Inflammatory Bowel Disease Treatment in Cork
Who treats IBD
Gastroenterologists lead diagnosis and medical management. They prescribe medication, monitor bowel inflammation, and coordinate surgical care if needed. Physiotherapy and rehabilitation focus on supporting the whole person: managing fatigue, musculoskeletal pain, bone health, and nervous system regulation.
Management rather than cure
IBD is chronic. Even with advanced medications, most people experience periods of flare and remission. The goal is not cure, but control of inflammation and improvement of daily function. Medical therapy reduces bowel inflammation, while rehabilitation addresses fatigue, mobility, strength, and resilience.
Medical treatment
Aminosalicylates (5-ASA drugs) for mild UC
Corticosteroids for short-term flare control
Immunomodulators (azathioprine, methotrexate) for long-term suppression
Biologics and small molecules (anti-TNF, anti-IL-12/23, JAK inhibitors) for moderate to severe disease
Surgery in complicated Crohn’s or severe UC
These therapies target bowel inflammation. Rehabilitation complements them by targeting the systemic effects of the illness.
Exercise therapy: why it matters in IBD
Exercise is now recognised as a safe and effective adjunct in IBD management. Research shows it improves quality of life, reduces fatigue, and may even lower inflammatory activity.
Why exercise helps:
Anti-inflammatory signalling: Contracting muscles release myokines such as IL-6, which promote downstream anti-inflammatory cytokines (IL-10, IL-1ra) and reduce TNF-α activity.
Immune regulation: Regular training can increase regulatory T-cells and improve the balance of Th17/Treg cells, pathways central in IBD.
Gut motility and function: Moderate activity supports healthy bowel motility and reduces stress-driven flares.
Bone and muscle health: Prevents osteoporosis and sarcopenia, which are common due to inflammation and steroid use.
Fatigue reduction: Aerobic and resistance training improve mitochondrial function and energy regulation, reducing debilitating fatigue.
The key is graded exercise with pacing. Too much too soon can worsen fatigue. Too little leads to deconditioning and greater flare risk. With professional support, exercise becomes sustainable and confidence-building.
At Neurokinetica, exercise therapy is tailored to:
Energy levels during remission or flare
Joint and back pain from extraintestinal arthritis
Bone density preservation with safe, progressive loading
Aerobic training adapted to gut sensitivity and fatigue
Somatic and mind–body practices
Stress and autonomic imbalance play a key role in IBD flare-ups. Practices that calm the nervous system reduce flare frequency and intensity.
Breathwork: Slow, diaphragmatic breathing enhances vagal tone, activating the cholinergic anti-inflammatory pathway.
Yoga therapy: Combines gentle movement, breathing, and attention training. Studies show benefits in fatigue, stress, and quality of life for IBD patients.
Guided relaxation and mindfulness: Reduce stress hormones that can trigger inflammation. Mindfulness training has been linked to reduced disease activity scores in IBD.
Somatic practices: Help patients move with less guarding and tension, improving overall resilience and comfort in the body.
Pain, fatigue, and brain fog
Even in remission, many patients experience chronic fatigue, musculoskeletal pain, and brain fog. These are influenced by systemic inflammation, disrupted sleep, and the psychological burden of unpredictable flares.
Rehabilitation strategies include:
Pacing: structuring daily activity to avoid boom–bust fatigue cycles
Graded exposure: slowly reintroducing activity to build tolerance without triggering crashes
Cognitive support: using movement and mindfulness to improve focus and clarity
Pain neuroscience education: explaining how persistent pain arises from sensitisation, and how safe movement rewires these pathways
Rehabilitation at Neurokinetica
At Neurokinetica, we work with people in Cork living with Crohn’s and ulcerative colitis to bridge the gap between medical treatment and daily life.
Our programmes include:
Targeted exercise therapy: strength, aerobic, and mobility training designed for energy fluctuations and bone health
Somatic and yoga-based therapy: calming the nervous system, reducing flare triggers, and restoring body confidence
Fatigue and pacing strategies: learning how to stay active without overdoing it
Education: understanding how pain, fatigue, and stress interact with your condition
We understand that IBD is not just about bowel inflammation. It is about the exhaustion that lingers even in remission, the unpredictability of flares, and the way fatigue, pain, and brain fog disrupt daily life.
Our goal is to help you move with confidence, conserve energy, and live with greater stability — not just when your condition is quiet, but through the ups and downs that come with IBD.
If you are looking for IBD adjunct rehabilitation in Cork and want a programme that combines exercise therapy, pacing, and mind–body practices, book a session to start your treatment pathway today.