What are the best types of physical activities for IBS?

by Annamaria Ambrosova

All around we hear about how important physical activity is for healthy living. The idea of physical activity is however particularly challenging for patients suffering from IBS. No one wants to go to the gym with abdominal pain and other uncontrollable IBS symptoms. That is why physical activity is understandably often avoided. Is it better to avoid it? What type of physical activity might be worth a try?

Low-to-moderate intensity physical activities are recommended

Low-intensity physical activities including walking, cycling, swimming, and yoga could help relieve abdominal symptoms. If these types of exercises are performed consistently, they also improve immune functions, reduce anxiety and other mental health concerns associated with IBS. In addition, they have a positive effect on gut microbiome and overall health.

The goal is about 20-60 minutes of physical activity three to five times a week. Here are some of the most commonly recommended:

Yoga

The most well-known type of yoga is Hatha yoga which focuses on different postures, maintaining balance, and breathing. This type of yoga can help improve flexibility and strengthen the core while also targeting the mind. Strengthening core muscles could help prevent the worsening of IBS symptoms, similar to overall physical fitness.

The alleviation of abdominal pain, nausea, constipation, and bloating was found after about 2 months of patients practicing yoga. Yoga can also improve symptoms of diarrhea. In some studies, it was shown to be even more effective than pharmacological medications such as loperamide.

Walking

Walking can also help improve gastrointestinal symptoms. It alleviates discomfort and reduces anxiety. The effects of walking are generally similar to the effects of yoga. The majority of people find it easier to stick to regular walking rather than yoga. It is generally easier for many people to choose walking since it can be done in most environments and can be connected with running errands or other typical daily activities.

How much should you walk?

It is recommended to walk every day. The effects are better the more regularly you walk. It does not mean that you need to reach the goal of 10,000 steps every day. It’s always important to listen to your body and take rest when you feel tired.

Swimming and cycling

Similar effects have been found with implementing swimming or low-speed cycling into your exercise routine. It is important to highlight that the improvement in IBS symptoms was better in patients with the IBS-C subtype rather than in those with diarrhea‐predominant IBS. This means that patients with IBS-D should be more gentle and opt for the particular exercise that does not worsen their symptoms.

What about running?

Some patients claim that running is even more effective in relieving their IBS symptoms. Running could especially be beneficial for patients with IBS-C. On the other hand, several patients believe that running could induce or exacerbate their IBS. Symptoms of ‘runner’s stomach’ are commonly associated with running, especially endurance running or running at high speed. These symptoms can be troublesome for IBS patients, and it is important to understand that every person’s gastrointestinal tract reacts differently under such stress. If you want to try running, make sure to start slowly and increase intensity or duration based on what your body can handle.

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Summary of effects of physical activity.

High-intensity physical activity may be troublesome

Similar to running, high-demanding physical activity can often be troublesome for IBS patients. This follows the theory that the risk for IBS symptoms increases as exercise intensity becomes more vigorous.

Professional athletes experience immunosuppression or many gastrointestinal symptoms, such as abdominal pain, diarrhea, and leaky gut syndrome when putting so much stress on their bodies.

Several studies mention that aerobic exercise can be a beneficial strategy for modulating the gut microbiome including exercises of moderate or vigorous intensity. This is especially effective for overweight patients. One of the possible reasons behind this is the improvement in cardiorespiratory fitness which correlates with greater microbial diversity. The benefits could however also be due to a combination of lifestyle changes since people who exercise regularly often make healthier dietary choices with a higher intake of fruits and vegetables.

Summary

Physical activity improves IBS symptoms, digestion, and mental health. It produces anti-inflammatory and antioxidant effects in IBS patients. Although the World Health Organization (WHO) recommends that adults should engage in aerobic and moderate-intensity exercise for at least 150–300 minutes per week or at least 75–150 minutes per week of high-intensity exercise, high-intensity exercise is generally not recommended for IBS patients. It might cause exacerbation of IBS symptoms and should be performed with caution.

Improved physical fitness could help reduce the intensity and frequency of IBS symptoms, just make sure to choose an activity that you can do consistently and that you also enjoy!

References

Bonomini-Gnutzmann, R., Plaza-Díaz, J., Jorquera-Aguilera, C., Rodríguez-Rodríguez, A., & Rodríguez-Rodríguez, F. (2022). Effect of Intensity and Duration of Exercise on Gut Microbiota in Humans: A Systematic Review. International Journal of Environmental Research and Public Health, 19(15), 9518. https://doi.org/10.3390/ijerph19159518

Radziszewska, M., Smarkusz-Zarzecka, J., & Lucyna Ostrowska. (2023). Nutrition, Physical Activity and Supplementation in Irritable Bowel Syndrome. Nutrients, 15(16), 3662–3662. https://doi.org/10.3390/nu15163662

Zhou, C., Zhao, E., Li, Y., Jia, Y., & Li, F. (2019). Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterology and Motility : The Official Journal of the European Gastrointestinal Motility Society, 31(2), e13461. https://doi.org/10.1111/nmo.13461