There’s a well-known saying that ‘exercise is medicine’, and for people living with irritable bowel syndrome (IBS), that may certainly be true. Whether it’s walking, tai chi, or yoga, regular physical movement has been shown to help relieve IBS symptoms and improve associated fatigue, depression, anxiety, and overall quality of life.

IBS is a long-term disorder of the gut-brain axis whereby communication between the gastrointestinal tract and the brain gets scrambled, leading to abdominal pain and altered bowel habits. Exercise may help normalize these gut-brain communications, improving your symptoms. 

And the best part? Exercise is free, accessible, and can be easily tailored to your lifestyle and fitness levels.

How exercise can help relieve IBS symptoms

A growing body of evidence shows exercise may be a smart addition to your IBS-management strategy, alongside other proven non-drug management tools such as a low-FODMAP diet and gut-directed hypnotherapy.

Reducing stress

Much is now known about the Stress-IBS loop. Studies have shown that people who experience IBS symptoms are more likely to have a flare-up during times of stress. It has also been shown that when stress, or anxiety has been reduced, so are IBS symptoms.

Exercise is a well-known tool for stress reduction. It’s thought that physical activity releases ‘happy hormones’ such as dopamine and serotonin that positively affect mood. 

A systematic review published in Neurogastroenterology and Motility showed that, by influencing the gut-brain axis, a range of exercises from tai chi to mountaineering helped boost the mood of those with IBS and notably decrease the severity of their symptoms.

Physical activity has also been shown to reduce inflammation and oxidative stress in the body, both of which are positively associated with IBS. A study published in Cytokine in 2018 found that 24 weeks of moderate-intensity aerobic exercise reduced harmful pro-inflammatory cytokines and peroxidative biomarkers, and increased protective anti-inflammatory and antioxidant parameters, so reducing the severity of IBS symptoms.

Other mechanisms that may explain the effects of exercise on IBS symptoms include increased and maintained oxygen uptake, and faster transit of gas and faeces through the colon to ease both bloating and constipation. 

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Which exercise is best for IBS?

Exercise works wonders for your health. But which exercises are best for soothing your IBS, and how long and how often do you need to move to get the benefits?  

The research published in Neurogastroenterology and Motility showed that yoga, walking and aerobic physical activity, tai chi, mountaineering, and qigong all helped to improve IBS symptoms. Other activities proven to ease symptoms include cycling and swimming.

A study published in PLoS One in May 2020 found that the more steps people with IBS took each day, the less severe their symptoms were. The authors found that, in subjects with severe symptoms, increasing the daily step count from 4,000 steps to 9,500 halved the severity of symptoms. 

This same study recommended that people with IBS exercise every day for at least 30 minutes. Another small study from January 2019 shows that women who spent 30 minutes on a treadmill just three times a week enjoyed milder IBS symptoms and improved quality of life.  

And it’s not enough to exercise for a few weeks or months if you want the effects to continue. Research shows you need to increase and maintain your physical activity over time.

One long-term follow-up study published in the World Journal of Gastroenterology measured the impact of increased and maintained physical activity five years after an initial 12-week intervention. It found a consistent, moderate exercise regime had long-term positive effects on IBS symptoms, quality of life, fatigue, anxiety, and depression.

Other studies reinforce that, once a fitness program ends, its effects on IBS symptoms decline over time, and markers of inflammation, oxidative stress, and antioxidants return to normal eight weeks after training.

It’s best then to choose an exercise that you enjoy so you can stick with it long-term. And try to set realistic goals. Aiming to run for an hour every day, then beating yourself up when you quit after a week, will only increase your stress and anxiety levels⸺making your symptoms worse.

Which exercise is worst for IBS?

All forms of exercise can help lower your stress and boost your mood, but it’s important to keep an eye on the intensity and length of your workouts. Placing too much physical stress on your body can be an IBS trigger.

When you exercise, your body directs blood away from your digestive tract to your limbs so you can flee danger faster. And pushing your body to extremes through, for example, running a marathon, can cause diarrhea through something called “localised ischemic colitis”, or a stressed colon.

If you have IBS, moderation is vital for working out. The study published in Cytokine showed that low-to-moderate intensity aerobic workouts are far more effective in managing IBS symptoms than either resting or exercising vigorously.

Practise self-care by paying attention to changes in your IBS symptoms and adjusting your exercise regime to suit. During a flare-up, you may want to choose ultra-soothing forms of exercise such as tai chi or yoga. And in times of remission, you could experiment with a more intense activity such as cycling.

Mixing up your routine will allow you to stay physically active and manage your symptoms while placing the least stress on your body.

The Wrap Up

Exercise can be an effective IBS symptom management tool. Used in moderation, it has been shown to reduce stress triggers of flare-ups and improve overall health. Exercise has the benefit of being free, easily accessible, and be able to be tailored to your current state of wellbeing. You may want to explore yoga or tai chi during times of flare-up and more intense exercise during remission. Talk to your doctor before embarking on a new exercise program, too, particularly if your IBS symptoms have kept you from exercising in the past.

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