Many individuals with IBS have questions about exercise, especially when they are going through a “flare,” or a particularly difficult set of symptoms. It is understandable that the idea of exercising while in pain would not be the first thing someone is inclined to do, but exercise can be incredibly helpful for IBS sufferers. Read on for more tips on this topic.
Benefits of Exercise
IBS symptoms are heavily influenced by stress; stress can cause increased symptoms, and then the anxiety or reduced quality of life that results from painful, uncomfortable or embarrassing symptoms can create further stress. It’s a vicious cycle, and our brains and our bodies sometimes feel at war. Exercise can help reduce this stress by stimulating the release of endorphins (feel good hormones) and lead to a greater sense of calm and/or well-being.
Exercise can also help increase your level of fitness and strengthen your body, which is good for overall health and longevity, and it can also leave you feeling stronger and more capable of handling your tough symptoms. And, as we know from years of research, exercise can help moderate blood sugar levels, reduce blood pressure, regulate sleep and help individuals manage their weight.
Finally, studies have shown that exercise can improve overall IBS symptom severity. A recent study compared two groups of IBS patients. The group of individuals who increased their exercise levels experienced a significant decrease in IBS symptoms, while the control group (those who did not increase their exercise levels) saw increased symptom severity/worsening of symptoms.
What Type of Exercise is Most Helpful?
The type, duration and intensity of exercise you decide to do will depend on your symptoms. If you’re feeling good, and you are generally healthy and your doctor says that exercise is safe for you, there are generally no limitations. Choose an activity that you enjoy and that you can comfortably do 3-5 days per week for 30-45 minutes at a time. For best health, 150 minutes of weekly physical activity are recommended. Vary your choices and have fun with it!
During a period of intense pain or abdominal discomfort, exercises that are very fast-paced and jarring, such as running, soccer, cross fit or other high-intensity activity, may cause greater discomfort. They will not harm you, but they certainly will not likely feel very comfortable. This again, will depend on your symptoms and IBS subtype. For example, individuals with IBS-C may benefit from more intense or endurance exercise, as it can speed up intestinal transit time and relieve constipation. However, individuals with IBS-D may find that some of these same gut changes (see below) can be more problematic.
Running, especially longer distances, can cause increased GI distress due to increases in gut permeability that results from reduced gut blood flow (while you exercise, your body is busy pushing blood to working muscles and away from the gut). Changes in nutrient absorption and gastric emptying time can also result, which can make runners more susceptible to cramping and diarrhea. In fact, it’s estimated that 30-83% of runners (even those without IBS) suffer from GI disturbances during longer runs. This doesn’t mean you shouldn’t run, but it does mean you may want to avoid it during a flare of IBS symptoms. You should also be careful of the foods you eat before and during a long run, as many have concentrated sugars (including fructose, a high FODMAP sugar) or caffeine, which may exacerbate symptoms. Kate Scarlata has a great booklet on this on her site, if you’d like more information. Dr. Dana Lis also has published research in this area, regarding utilizing the low FODMAPs diet for endurance athletes who suffer from exercise-induced GI distress.
So, what types of exercise should you try when you’re not feeling good? Gentle or low-impact activities such as walking, yoga, light cycling, tai chi or swimming can all be amazing stress reducers, while also being really good for your body. Getting outdoors to exercise is also encouraged, as the effects of daylight and external environmental cues (e.g. being in nature!) have been shown to improve mood and reduce anxiety.
Yoga has been studied quite a bit by GI researchers, and a recent study showed that individuals with IBD (inflammatory bowel disease) found improved quality of life and an improved state of their disease (e.g. fewer symptoms) with weekly yoga sessions. Another recent study, which compared yoga to the low FODMAPS diet, found that twice weekly yoga was nearly as effective in reducing IBS symptom severity as the low FODMAPS diet. Yoga was also found to be very helpful in regard to reducing patients’ levels of anxiety and increasing body awareness and responsiveness. In a scientific review of a number of studies that evaluated yoga practice for IBS sufferers, it was also noted that the improvements in symptoms and quality of life gained from yoga practice may also lead to reduced need for medications, fiber supplements and probiotics. Thus, a combination of yoga and the low FODMAPS diet should be quite helpful for many IBS sufferers!
The Bottom Line
When starting a new exercise program, or if you are feeling pretty uncomfortable, start slow and listen to your body. And, be sure to fuel up for activity with nutritious foods and hydrate well. But stick with it. Your overall health and quality of life can benefit tremendously!
And, as always, please check with your doctor before starting a new exercise program to make sure it is appropriate for your age, lifestyle and current health status.
If you’d like to read more on this topic, here are a few studies not previously linked to above: