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DOES EXERCISE HELP IBS?

THE SHORT ANSWER IS YES

Our bodies were built to move, so in the modern world where many people have desk jobs, cars for commuting and TVs and sofas for down time, it comes as no surprise that a large proportion of the population is affected by illnesses from a sedentary lifestyle: obesity, diabetes and heart disease.

While there is no evidence that Irritable Bowel Syndrome (IBS) can be caused by a person’s lifestyle, there is clear evidence, supported by medical studies that positive changes in lifestyle can greatly help IBS symptoms and improve patients’ quality of life.

WHAT IBS SYMPTOMS CAN EXERCISE HELP TO IMPROVE?

  • Constipation in IBS-C and IBS-M
  • Gassiness
  • Stress
  • Anxiety and related insomnia/disturbed sleep
  • Lack of energy/tiredness

Exercise and movement help the gut’s motility. They increase muscle activity in the digestive tract which means the stool and gas move faster along the gut. Exercise also has a positive effect on the mind, helping to de-stress, re-energise and boost the ‘happy hormone’ serotonin.

Exercise and movement help the gut’s motility.

What physical activities are the best for IBS?

YOGA

There are many types of yoga available for all levels. For the best benefit to mind and body, people with IBS are advised to choose a slow-paced variety, featuring breathing practice, meditation and some of the following poses:

There are many types of yoga available for all levels.

Ananda Balasana
(Happy Baby Pose)

There are many types of yoga available for all levels.

Pavanamuktasana
(Wind Relieving Pose)

What physical activities are the best for IBS? YOGA

Parighasana
(Gate Pose)

For the best benefit to mind and body, people with IBS are advised to choose a slow-paced variety, featuring breathing practice, meditation and some of the following poses:

Ardha Matsyendrasana
(Half-Seated Spinal Twist)

For the best benefit to mind and body, people with IBS are advised to choose a slow-paced variety, featuring breathing practice, meditation and some of the following poses:

Dhanurasana
(Bow Pose)

TAI CHI

This Chinese martial arts practice is often called a “meditation in motion,” for its slow-paced, unforced movements accompanied by deep breathing and concentration on body sensations. It is suitable for people of all physical abilities and is often recommended as the rehabilitation exercise of choice for people recovering from accidents or medical operations. For IBS patients it helps with emotional wellbeing as well as providing gentle exercise.

This Chinese martial arts practice is often called a “meditation in motion,”

CARDIO/AEROBIC EXERCISE

From light jogging to a challenging cross-fit session, cardio/aerobic exercise can provide the body’s necessary movement levels, speeding up metabolism and improving digestive and overall health. In a recent IBS study, patients who were introduced to 20 to 60 minutes of moderate to intense exercise several times a week demonstrated impressive results in symptom reduction compared to those whose activity levels stayed the same. All activities used in this study were of a ‘cardio’ type, including running, cycling, fast walking and swimming. Dancing is another activity credited for its positive effect on the well-being of IBS patients.

As with any dietary regime, the choice, frequency and intensity of workouts should be agreed with a doctor. Some more vigorous exercises may need to be avoided. Many IBS-D sufferers are cautious about running for the fear of ‘Runners Diarrhoea’.

Runners Diarrhoea – is a condition which is caused by inflammation of the colon – colitis. It usually affects athletes with a very intense training schedule – running fast and long distances. IBS patients may opt for a lighter jog and consult with their doctor prior to commencement of training.

When putting together the training plan for people with IBS, there are few suggestions how to make it most beneficial:

  • Exercise at regular times, creating a routine
  • Choose an activity where you can stay hydrated at all times
  • Include mindful exercise in your training schedule
  • Donot exercise close to meal times (best to allow at least two hours before and after a meal)
  • Exercise when you feel most energetic (morning for early birds and evening for night owls)

Staying active throughout the day is as important (if not more) as hitting the gym a few times a week. Increasing the amount of walking, standing and other light activity – anything opposite to sitting or lying down – can have a positive effect on the overall health of a person whether they have IBS or not.

WHY TRY EXERCISE?

Less than one-third of IBS patients reported satisfaction with their current IBS therapies in a large-scale study, and only 45% stated that their prescription drugs were “effective”1.

Many people with IBS are looking at alternative forms of therapy, one of which is exercise. There is a growing body of evidence to support moderate regular exercise can help improve symptoms.

In a recent study2, 109 women with IBS and a sedentary lifestyle undertook 24 weeks of moderate aerobic exercise. The results were promising with a significant improvement in symptoms and a reduction in the levels of biomarkers of inflammation. They suggested that exercise could have a modulating effect on both immune functions and oxidative stress.

Another randomized controlled trial involving 102 patients with IBS found that patients in the exercise group over a 12-week activity period had fewer IBS symptoms compared with the control group (8 versus 23%)3. The symptoms of emotion, sleep, energy, physical functioning, and social and physical role were significantly improved in the exercise group. However, there was no change in the self-reported bowel movements per week and stool consistency between the exercise and control groups. Continuation of moderate exercise for a further 12 weeks, had a long-term positive effect on IBS symptoms, quality of life, fatigue, anxiety and depression4.

The exact mechanism by which exercise improves symptoms is not fully understood, although clinicians agree that exercise overall increases gut motility. This suggests that increasing gut motility would most benefit patients with constipation-predominant IBS (IBS-C) and least benefit patients with diarrhoea-predominant IBS (IBS-D). However, to date studies looking at exercise in IBS patients haven’t distinguished IBS into the different subgroups, so at the present time it isn’t known if exercise affects patients differently depending on their IBS subgroup.

The UK National Institute for Health and Care Excellence (NICE) recommend that people with IBS who currently have low physical activity levels should try to increase their activity levels.

Adults should aim to do 30 minutes of moderate intensity physical activity on at least 5 days of the week. This daily activity can be in a single session, or several sessions of at least 10 minutes each.

Activity can be lifestyle-based; climbing stairs, walking and cycling, or structured exercise; fitness training session, dance class or outdoor sport, or a combination of these.

However, increased physical activity may not be appropriate for people with diarrhoea-predominant IBS (IBS-D), and people with certain medical conditions.

1. International Foundation for Functional Gastrointestinal Disorders. IBS in the real world survey. Summary findings. August 2002. Available from http://www.iffgd.org/images/pdfs/IBSRealWorld.pdf.
2. Hajizadeh Maleki B, et al. Cytokine. 2018 Feb;102:18-25.
3. Johannesson E, et al. Am J Gastroenterol.2011;106(5):915-922.
4. Johannesson E, et al. World J Gastroenterol 2015; 21(2): 600-608