IBS and physical activity – what you need to know

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder characterised by abdominal pain, bloating, changes in bowel habits and discomfort. Although diet and stress reduction are key elements in controlling it, the role of physical activity is increasingly being recognised. However, the question arises as to whether exercise can alleviate symptoms or, on the contrary, exacerbate them.

1. Can exercise help?
2. When does exercise become a problem?
3. The best types of exercise
4. What is best to avoid?
5. How to exercise wisely with IBS?
6. When to see a doctor?
7. Summary

Can exercise help?

Recent studies have shown that regular low- to moderate-intensity activity can reduce some IBS symptoms, including bloating and abdominal pain. Participants in several clinical trials reported an improvement in their quality of life and mental well-being, which may be significant given the close relationship between the gut and the nervous system. However, I must emphasise that the evidence is still limited and inconclusive, and the effects can vary from person to person. For some, walking, swimming or gentle breathing exercises bring significant relief, while others see little change.

When does exercise become a problem?

On the other hand, we know that intense, prolonged and exhausting exercise can worsen symptoms. People who train for endurance sports – such as marathons, triathlons or long hours of cycling – often experience so-called exercise-induced gastrointestinal symptoms. These include bloating, sudden urge to defecate, diarrhoea and reflux. Studies have shown that up to 70% of professional runners experience these types of difficulties. This is due, among other things, to a temporary "leak" in the intestinal barrier and a decrease in blood flow through the digestive tract during intense training, which can exacerbate IBS symptoms in sensitive individuals.

The best types of exercise

As a trainer and nutritionist, I recommend moderate activity that does not overload the body. These include walking, recreational cycling, swimming and jogging at a leisurely pace. Yoga, a combination of physical, breathing and relaxation exercises, is also becoming increasingly popular. Although research on its effect on IBS is still limited, several trials have reported a reduction in stress levels and a subjective improvement in symptoms. Regular aerobic exercise three times a week for several months was also associated with a reduction in abdominal pain and an improvement in mood in the subjects.

What is best to avoid?

People with IBS should exercise caution when engaging in long-term and highly intensive training, such as intervals, long-distance running or sports involving jumping and jolting. Jumping and intense running can increase pressure in the abdominal cavity, which intensifies pressure and bloating. It is also worth remembering that exercise tolerance can change over time, and the body's response to the same type of exercise can vary depending on your current state of health and the phase of your symptoms.

How to exercise wisely with IBS?

It is best to start with short and light activities, gradually increasing the time and intensity. Keeping a diary of your exercise and symptoms allows you to assess which forms of exercise are beneficial and which exacerbate your symptoms. It is a good idea to choose comfortable, loose-fitting clothing and make sure you stay hydrated, as dehydration can worsen constipation. It is also important to pay attention to the ingredients in products – some sweeteners, such as sorbitol and xylitol, belong to the FODMAP group and can cause IBS-like symptoms in sensitive individuals.

When to see a doctor?

Although IBS is a chronic condition that is usually not life-threatening, some symptoms require medical consultation. Seek help if you experience sudden weight loss, blood in your stool, a lump or swelling in your abdomen, or persistent, severe pain. These may suggest other, more serious gastrointestinal diseases that require diagnosis and treatment.

Summary

Physical exercise can be a valuable aid in controlling IBS, but its role depends on the intensity and individual response of the body. Moderate activity, such as walking, swimming, cycling or yoga, often brings benefits and improves quality of life. However, excessive exercise can have the opposite effect and exacerbate symptoms. Therefore, the best strategy is to gradually try out different forms of exercise, observe your body and choose activities that do not worsen your intestinal comfort.

Sources:

Johannesson E et al. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol.

Keefer L et al. Behavioral interventions for the self-management of irritable bowel syndrome. Gastroenterol Clin North Am.

Costa RJS et al. Systematic review: exercise-induced gastrointestinal syndrome—implications for health and intestinal disease. Aliment Pharmacol Ther.

Johannesson E, Ringström G. Exercise and irritable bowel syndrome: a randomized controlled trial. World J Gastroenterol.

Schumann D et al. Yoga-based therapy for irritable bowel syndrome: a randomized controlled trial. Clin Gastroenterol Hepatol.

van Nieuwenhoven MA, Brouns F. The effect of physical exercise on gastrointestinal function and symptoms in irritable bowel syndrome. Curr Opin Clin Nutr Metab Care.