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Discuss physical activity as part of symptom management for IBS
Discuss physical activity as part of symptom management for IBS
PEARLS No.
707
Clinical question
How effective and safe are physical activity interventions for adults diagnosed with irritable bowel syndrome (IBS)?
Bottom line
The results from a small body of low and very-low‐certainty evidence suggest physical activity, comprising of yoga, treadmill exercise or advice and support to increase physical activity, may improve symptoms in people diagnosed with IBS.
The level of improvement in IBS was clinically important, with an absolute mean reduction of 69 points (95% confidence interval 31–106) for total symptoms on the IBS severity scoring system.
Physical activity did not seem to improve quality of life or abdominal pain in people diagnosed with IBS. There was not enough evidence to assess adverse effects associated with physical activity interventions.
Caveat
The longest duration of intervention was 24 weeks, and the longest period of follow‐up was 6 months. Therefore, there is uncertainty about the effect of longer interventions and the impact of short‐term interventions on long‐term outcomes.
The extent to which the results are applicable to people with constipation‐predominant IBS or diarrhoea‐predominant IBS is uncertain as most studies included people with mixed episodes of diarrhoea or constipation.
Context
IBS is a common, chronic functional bowel disorder characterised by symptoms that include episodes of abdominal pain, bloating and changes in bowel habit.
In healthy people, moderate physical activity reduces intestinal gas retention, improves gas transit time and reduces abdominal distension. Physical activity also reduces colonic transit time, incomplete defaecations and hard stools in people with constipation, which is a common symptom in people with IBS. Further, physical activity may improve symptoms in people with other gastrointestinal conditions, such as peptic ulcers, cholelithiasis and diverticular disease, and is associated with reduced incidence of inflammatory bowel disease.
Cochrane Systematic Review
Nunan D, et al. Physical activity for treatment of irritable bowel syndrome. Cochrane Database Syst Rev 2022;6:CD011497. This review contains 11 trials with a total of 622 participants.
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