Managing Exercise and Your IBS Symptoms

A group strength workout on spin bikes

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If you have been diagnosed with irritable bowel syndrome (IBS), exercise can be daunting. Intense workouts may aggravate the condition, causing abdominal pain, cramps, and things diarrhea. But if you're keen on exercise or want to work out to be healthier, there are ways to exercise without making your IBS symptoms worse.

Benefits and Risks

While the relationship between IBS and exercise remains unclear, exercise is known to reduce many of the stresses that can potentially contribute to IBS symptoms. This includes psychosocial stresses that go hand in hand with acute flares.

Many people worry that the intensity of exercise will set off IBS symptoms. After all, compressing, stretching, and jostling the intestines is known to cause flares of many gastrointestinal conditions, including exercise-induced reflux.

Moreover, high-intensity interval training (HIIT) will almost invariably create excess body heat, contributing to the risk of diarrhea. It is certainly why some people get runners' diarrhea when running too fast or too long.

Key to exercising effectively with IBS is the avoidance of sudden high-intensity workouts. More is not always better. In fact, exercising with moderate intensity tends to be far more effective in managing IBS symptoms than either sitting in a chair or exercising vigorously.

According to a study in the World Journal of Gastroenterology, exercising an average of 5.2 hours per week improves both the physical and psychological symptoms of IBS as measured by the IBS Severity Scoring System (IBS-SSS).

Walking, aerobics, and cycling were among the three most common (and beneficial) forms of exercise in people with IBS.

Practical Tips

Having IBS doesn't mean that you have to avoid strenuous activity altogether. After all, "strenuous" means different things to different people. If you enjoy running, you shouldn't necessarily stop running unless it causes you problems. If it does, pull back a little, reducing either the time or intensity of your training.

On the flip side, it doesn't help to be afraid of breaking into a good sweat. If you are able to manage fine at your current level, increase the intensity of your workout gradually every couple of weeks or so. This is especially important if you are trying to lose weight or build lean muscle. If you keep at the same pace week after week, you'll simply hit a plateau.

What you don't want to do is suddenly train beyond your limits. If you do, your body will respond by releasing cortisol (a stress hormone) and inflammatory compounds called cytokines, both of which can trigger an IBS flare.

Preparing for a workout also helps. Among some of the practical tips to consider:

  • Avoid eating two hours before exercise. This may mean working out first thing in the morning.
  • Avoid caffeine or hot drinks before exercising. Both have the potential for speeding up contractions.
  • Avoid eating fatty or gas-producing foods prior to exercise.
  • Time your workouts so that you exercise when your intestines are normally quieter.

If you are experiencing acute or recurrent bouts of diarrhea that don't improve with treatment, you may want to restrict yourself to less intense exercises such as walking, swimming, weight training, or yoga until you gain better control of your symptoms.

Alternatives to Running

Walking may sound boring if you're used to running miles, but walking at a relatively fast pace—such as completing 15-minute miles—may be a good compromise until you are able to get on top of your IBS symptoms.

While jerky movements can irritate the gastrointestinal tract, brisk walking keeps your abdomen relatively steady and allows you to pay closer attention to your core muscles.

There are several ways to get a greater lower and upper body workout while walking:

  • Focus on your core. Your intestines are jostled all over the place when running. Walking allows you to protect your intestines by keeping the core muscles taut for the duration of your workout. By paying attention to your core, you will likely develop better core strength than by running the same distance.
  • Try run-walking. Run-walking is trickier than it sounds. The rule is simple: never allow both feet to be off the ground at the same time. You can still move briskly but will have better control of our body. You'll find that your core is firmer and there is less impact on the legs, knees, lower back, and abdomen. It also gives you a good cardio workout.
  • Don't let your arms hang. When run-walking, the elbows are always bent and the forearms are parallel to the ground and close to your body. This keeps your core steady and reduces side-to-side twisting.
  • Use hand weights. Using neoprene hand weights or weighted gloves while run-walking provides you with additional resistance to build your biceps and lower body. As light as the weights may seem, you will definitely feel them after a brisk 20- to 30-minute walk.
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  1. Hajizadeh maleki B, Tartibian B, Mooren FC, et al. Low-to-moderate intensity aerobic exercise training modulates irritable bowel syndrome through antioxidative and inflammatory mechanisms in women: Results of a randomized controlled trial. Cytokine. 2018;102:18-25. doi:10.1016/j.cyto.2017.12.016

  2. Johannesson E, Ringström G, Abrahamsson H, Sadik R. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World J Gastroenterol. 2015 Jan 1421(2):600-8. doi:10.3748/wjg.v21.i2.600