Living with "Bathroom Issues": Inflammatory Bowel Disease in Pediatric and Adolescent Athletes.

Inflammatory bowel disease is a chronic, increasingly prevalent condition among children and adolescent athletes. Presenting with a wide range of gastrointestinal symptoms, inflammatory bowel disease also affects up to 30% of children through extraintestinal manifestations, including musculoskeletal, ocular, and dermatologic involvement. These symptoms can directly impair athletic performance and participation. Athletes with inflammatory bowel disease frequently report diminished physical activity levels, cardiorespiratory fitness, strength, agility, and flexibility compared to healthy peers. Additionally, psychological challenges such as stress, anxiety, and depressive symptoms may further impact sports engagement and overall well-being. Despite these challenges, physical activity remains a cornerstone of supportive care, offering both psychosocial benefits and potential anti-inflammatory effects. This review outlines practical strategies for sports medicine professionals to support athletes with inflammatory bowel disease. A multidisciplinary approach - integrating gastroenterology, sports medicine, behavioral health, and coaching - can help optimize outcomes and ensure that athletes with inflammatory bowel disease remain active, resilient, and well-supported in their athletic pursuits.