“Exercise is part of the behavioral health and holistic care necessary to improve the brain-gut axis and outcomes in IBS,” says Brennan Spiegel, MD, a gastroenterologist and a professor of medicine and public health and the director of health services research at Cedars-Sinai in Los Angeles. A review published in September 2018 in Neurogastroenterology and Motility looked at various exercises spanning a wide range of intensity from tai chi to mountaineering. It found that each of the exercises helped reduce IBS symptoms and improved mood. But is one exercise better than another when it comes to IBS pain relief? “The best exercise is the one that you will do and stick with,” says Megan Riehl, PsyD, a gastrointestinal psychologist at Michigan Medicine in Ann Arbor, Michigan. Here are five expert recommended activities proven to improve IBS symptoms. One caveat: Always talk to your doctor before beginning a new exercise routine, especially if abdominal pain, IBS symptoms, or gastrointestinal (GI) distress have kept you from working out for an extended period.
1. Yoga Improves Digestion and Mood
While there are many types of yoga, some more aerobic than others, they all follow the basic principles of connecting the brain, body, and breath through a series of stationary poses and active movements. A review published in December 2019 in Digestive Diseases and Sciences found that study participants who started a yoga practice improved their digestion, reduced their IBS symptoms, and felt stronger. They also reported less depression and anxiety. “We believe yoga is a very effective treatment for IBS because the focus on the mind-body connection improves the messages traveling from the brain to the gut and the gut to the brain,” says Brian E. Lacy, MD, PhD, a gastroenterologist at the Mayo Clinic in Jacksonville, Florida. If you’re just starting out, try classes for beginners, which are sometimes labeled “gentle,” or ones that focus on stress relief, until you’re ready for a more intense class.
2. Tai Chi Helps Connect the Body to the Breath
Like yoga, tai chi also involves connecting the brain, body, and breath through a series of slow, graceful movements coupled with deep breathing into the diaphragm. The review published in Neurogastroenterology and Motility looked at a previous study that tracked two groups of IBS patients for eight weeks — both groups took medication, but one group did tai chi while the other didn’t. The group that did tai chi for eight weeks had fewer and less severe symptoms than the control group. Tai chi is effective, because it helps reduce stress. “Physical and emotional stress doesn’t help any of us,” says Dr. Riehl. “It raises our cortisol levels and that can impact our digestive system. People with IBS have trouble down-regulating digestive stress. So, checking in with your breath, slowing your breathing down and bringing the breath into the diaphragm kick-starts the parasympathetic system, calms everything down, and gives a nice massage to the digestive organs that can reduce spasms and urgency.”
3. Walking Eases Symptoms
Getting in your daily steps with a walk or a light jog burns calories, helps regulate blood sugar levels, and works several large muscle groups. A study published in May 2020 in PLoS One found that the more steps people with IBS took per day, the less severe their symptoms were. And in a study published in February 2018 in the Journal of Bodywork and Movement Therapies, participants who did six weeks of exercise on a treadmill for just 30 minutes three times a week saw significant improvement in their IBS symptoms and their mood. “Taking a walk aids digestion,” says Dr. Lacy. “It can help relieve constipation and it can help move gasses to alleviate abdominal pain. Plus, being outside in the fresh air and moving is good for your mental health. And, that’s good for your GI health.”
4. Cycling Lets You Vary Intensity
Hopping on a bike, whether stationary or on the road, is a great workout for the legs and the heart. Lacy champions it for the amount of control it gives to the rider since you can easily ramp up your pedaling for more intensity or slow it down and cruise for a leisurely ride. “It’s a great aerobic activity that’s safe, enjoyable, and low-impact,” he says. A study published in January 2015 in the World Journal of Gastroenterology found that IBS patients who maintained a cycling, or other exercise, habit had improved symptoms and overall health five years after they started exercising.
5. Swimming Is a Full Body Workout That Boosts Your Mood
Swimming is a great aerobic, low-impact exercise that gets your arms, legs, and core working. “Water aerobics can be very gentle but challenging,” says Riehl. “Plus, swimming makes you focus on your breath. It’s great for reducing cortisol stress levels, boosting your endorphins, and feeling great.” Research shows that getting in the pool works wonders for our mental health. A study published in 2019 in the Brazilian journal Clinics showed that aquatic exercises reduced anxiety and stress in elderly patients. That’s important since anxiety and stress often trigger IBS symptoms. Riehl notes that swimming rarely, if ever, leads to cramping or urgent diarrhea for people with IBS.
Moderation Matters When It Comes to Exercise
Stories of cyclists and marathon runners losing control of their bladder or defecating on themselves are not uncommon. According to Dr. Spiegel, when you exercise your body endures a physical stress that does not prioritize the gut, which decreases blood flow to the abdomen. “Pushing it to an extreme can lead to urgent diarrhea from something called localized ischemia in the colon,” says Lacy. “It underscores the need to exercise in moderation rather than push yourself to an extreme level.” Just 30 minutes on a treadmill three times a week was enough to reduce IBS symptoms in the Journal of Bodywork and Movement Therapies study. “Exercising in moderation is great for your physical and emotional health, and it helps you sleep better, which is great for digestion,” says Lacy.
