Original Contribution | Published:

Functional GI Disorders

Physical Activity Improves Symptoms in Irritable Bowel Syndrome: A Randomized Controlled Trial

The American Journal of Gastroenterology volume 106, pages 915922 (2011) | Download Citation

Abstract

OBJECTIVES:

Physical activity has been shown to be effective in the treatment of conditions, such as fibromyalgia and depression. Although these conditions are associated with irritable bowel syndrome (IBS), no study has assessed the effect of physical activity on gastrointestinal (GI) symptoms in IBS. The aim was to study the effect of physical activity on symptoms in IBS.

METHODS:

We randomized 102 patients to a physical activity group and a control group. Patients of the physical activity group were instructed by a physiotherapist to increase their physical activity, and those of the control group were instructed to maintain their lifestyle. The primary end point was to assess the change in the IBS Severity Scoring System (IBS-SSS).

RESULTS:

A total of 38 (73.7% women, median age 38.5 (19–65) years) patients in the control group and 37 (75.7% women, median age 36 (18–65) years) patients in the physical activity group completed the study. There was a significant difference in the improvement in the IBS-SSS score between the physical activity group and the control group (−51 (−130 and 49) vs. −5 (−101 and 118), P=0.003). The proportion of patients with increased IBS symptom severity during the study was significantly larger in the control group than in the physical activity group.

CONCLUSIONS:

Increased physical activity improves GI symptoms in IBS. Physically active patients with IBS will face less symptom deterioration compared with physically inactive patients. Physical activity should be used as a primary treatment modality in IBS.

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References

  1. 1.

    , , . Prevalence, comorbidity and impact of irritable bowel syndrome in Norway. Scand J Gastroenterol 2006;41:650–656.

  2. 2.

    , . Prevalence of irritable bowel syndrome according to different diagnostic criteria in a non-selected adult population. Aliment Pharmacol Ther 2004;20:339–345.

  3. 3.

    , , et al. Prevalence of irritable bowel syndrome: a community survey. Br J Gen Pract 2004;54:495–502.

  4. 4.

    , , et al. Functional bowel disorders and functional abdominal pain. Gut 1999;45 (Suppl 2): II43–II47.

  5. 5.

    , , et al. Health-related quality of life in patients attending a gastroenterology outpatient clinic: functional disorders versus organic diseases. Clin Gastroenterol Hepatol 2006;4:187–195.

  6. 6.

    , , et al. Migraine, fibromyalgia, and depression among people with IBS: a prevalence study. BMC Gastroenterol 2006;6:26.

  7. 7.

    , , et al. Quality of life in patients with irritable bowel syndrome seen in referral centers versus primary care: the impact of gender and predominant bowel pattern. Scand J Gastroenterol 2001;36:545–552.

  8. 8.

    , , et al. Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosom Med 2007;69:587–596.

  9. 9.

    . Exercise in fibromyalgia. Curr Opin Rheumatol 2005;17:190–194.

  10. 10.

    , , et al. Case-control study of lifetime occupational and recreational physical activity and risks of colon and rectal cancer. Eur J Cancer Prev 2005;14:363–371.

  11. 11.

    , , et al. Leisure-time physical activity patterns and risk of colon cancer in women. Int J Cancer 2007;121:2776–2781.

  12. 12.

    , , et al. Inverse association between physical inactivity and mental health in men and women. Med Sci Sports Exerc 2006;38:173–178.

  13. 13.

    , , et al. Effects of physical activity on intestinal gas transit and evacuation in healthy subjects. Am J Med 2004;116:536–539.

  14. 14.

    , , et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol 2005;40:422–429.

  15. 15.

    , , et al. Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract. Gut 2001;48:435–439.

  16. 16.

    , , et al. Gastrointestinal symptoms in long-distance runners, cyclists, and triathletes: prevalence, medication, and etiology. Am J Gastroenterol 1999;94:1570–1581.

  17. 17.

    , , et al. Does a physically active lifestyle improve symptoms in women with irritable bowel syndrome? Gastroenterol Nurs 2001;24:129–137.

  18. 18.

    , , et al. Effects of an irritable bowel syndrome educational class on health-promoting behaviors and symptoms. Am J Gastroenterol 1998;93:901–905.

  19. 19.

    . Allmänna rekommendationer om fysisk aktivitet. In Ståhle A (ed.) Physical Activity in the Prevention and Treatment of Disease. Swedish National Institute of Public Health: Sandviken, 2003, 65–71.

  20. 20.

    American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998;30:975–991.

  21. 21.

    , , . The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther 1997;11:395–402.

  22. 22.

    , , et al. Evaluation of a new quality of life questionnaire for patients with irritable bowel syndrome. Aliment Pharmacol Ther 1997;11:547–552.

  23. 23.

    , , et al. Alosetron improves quality of life in women with diarrhea-predominant irritable bowel syndrome. Am J Gastroenterol 2001;96:455–459.

  24. 24.

    , , . The Swedish SF-36 Health Survey—I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 1995;41:1349–1358.

  25. 25.

    , , . Hälsoenkät Manual och Tolkningsguide (SF-36 Health Survey, Swedish Manual and Interpretation Guide). Sahlgrenska Universtity Hospital: Göteborg, 2002.

  26. 26.

    , . The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361–370.

  27. 27.

    , , et al. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis 1994;18 (Suppl 1): S79–S83.

  28. 28.

    , . A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol 1954;7:218–221.

  29. 29.

    , , . Gender differences in gut transit shown with a newly developed radiological procedure. Scand J Gastroenterol 2003;38:36–42.

  30. 30.

    , . Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920–924.

  31. 31.

    . In the clinic. Irritable bowel syndrome. Ann Intern Med 2007;147:ITC7-1–ITC7-16.

  32. 32.

    , , et al. A course of instruction for women with irritable bowel syndrome. Patient Educ Couns 2006;62:118–125.

  33. 33.

    , , et al. The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants. Clin Gastroenterol Hepatol 2005;3:992–996.

  34. 34.

    , , et al. Altered visceral perceptual and neuroendocrine response in patients with irritable bowel syndrome during mental stress. Gut 2004;53:1102–1108.

  35. 35.

    , , et al. Neurobiology of exercise. Obesity 2006;14:345–356.

  36. 36.

    , , et al. Physical activity and intestinal gas clearance in patients with bloating. Am J Gastroenterol. 2006;101:2552–2557.

  37. 37.

    , , et al. Long-term physical activity patterns and health-related quality of life in US women. Am J Prev Med 2007;32:490–499.

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Acknowledgements

We thank the registered physiotherapist Emma Hellström for help with the data collection.

Author information

Affiliations

  1. Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    • Elisabet Johannesson
    • , Magnus Simrén
    • , Hans Strid
    • , Antal Bajor
    •  & Riadh Sadik

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Competing interests

Guarantor of the article: Riadh Sadik, MD, PhD.

Specific author contributions: All the authors were involved in the planning and conduct of this study. All authors were involved in the writing of this manuscript and have discussed, changed, and accepted the final version.

Financial support: This study was supported by the Health and Medical Care Executive Board of the Västra Götaland Region and by the Research and Development Council in Södra Älvsborg, Sweden.

Potential competing interests: None.

Corresponding author

Correspondence to Riadh Sadik.

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DOI

https://doi.org/10.1038/ajg.2010.480

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