A practical guide to the proper prescription of physical activity in patients with irritable bowel syndrome

Costantino, Andrea; Pessarelli, Tommaso; Vecchiato, Marco; Vecchi, Maurizio; Basilisco, Guido; Ermolao, Andrea

doi:10.1016/j.dld.2022.08.034

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…yoga, meditation) may help. Several randomized and non-randomized studies showed physical exercise, including yoga, is useful in the management of IBS [97][98][99][100][101][102]. A few studies compared yoga with either anti-anxiety medications or a low-FODMAP diet and found that yoga was either as good as anti-anxiety medications or was better than a low-FODMAP diet [103,104].…”

Section: Grade Of Recommendation: Bmentioning

confidence: 99%

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Ghoshal

Sachdeva

Pratap

et al. 2023

Indian J Gastroenterol

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The Indian Neurogastroenterology and Motility Association (INMA), earlier named the Indian Motility and Functional Diseases Association developed this evidence-based practice guidelines for the management of irritable bowel syndrome (IBS). A modified Delphi process was used to develop this consensus containing 28 statements, which were concerning diagnostic criteria, epidemiology, etiopathogenesis and comorbidities, investigations, lifestyle modifications and treatments. Owing to the Coronavirus disease-19 (COVID-19) pandemic, lockdowns and mobility restrictions, web-based meetings and electronic voting were the major tools used to develop this consensus. A statement was regarded as accepted when the sum of “completely accepted” and “accepted with minor reservation” voted responses were 80% or higher. Finally, the consensus was achieved on all 28 statements. The consensus team members are of the view that this work may find use in teaching, patient care, and research on IBS in India and other nations.

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Section: Grade Of Recommendation: Bmentioning

confidence: 99%

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Ghoshal

Sachdeva

Pratap

et al. 2023

Indian J Gastroenterol

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“…It is likely that in some patients the ingestion of gluten-containing foods may have a nocebo effect, while in others the avoidance of gluten-containing foods could have a placebo effect ( 88 ). When wheat-sensitive IBS is suspected, also non-diet specific treatments should be considered, such as neuromodulators, probiotics, and physical activity ( 84 , 89 , 90 ).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic management of patients reporting symptoms after wheat ingestion

et al. 2022

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Many patients report symptoms after wheat ingestion experiencing a wide spectrum of clinical manifestations. Three possible diagnoses have been recognized: celiac disease (CD), wheat allergy (WA), and non-celiac (gluten) wheat sensitivity (NCGS/NCWS). CD is a chronic immune-mediated disease of the small bowel caused by exposure to dietary gluten in genetically predisposed individuals, with a prevalence of approximately 1%. It is characterized by mucosal inflammation and atrophy following exposure to gluten and improvement after gluten withdrawal. Food allergies are immunological responses to a food antigen. WA is the expression of an immunologically mediated process that can be immunoglobulin E (IgE) or non-IgE mediated; its many symptoms include urticaria/angioedema, asthma, rhinitis, and anaphylaxis. NCGS/NCWS is characterized by gastrointestinal and/or extra-intestinal symptoms after ingestion of gluten-containing food in subjects not affected by CD or WA. The aim of this review is to help physicians and nutritionists diagnose the cause of symptoms reported after wheat ingestion, thus avoiding patient frustration, inappropriate testing, and incorrect or missed diagnoses. An algorithm for the diagnostic approach in these patients is provided, to help to diagnose CD, WA, NCGS/NCWS or to identify possible functional disorders as the wheat-sensitive irritable bowel syndrome. A personalized approach, regular follow-up, and the help of a skilled healthcare professional are mandatory for patients with symptoms following wheat ingestion is provided. A gluten-free-diet is often recommended for patients with self-reported gluten/wheat-dependent symptoms; for patients with symptoms similar to those of functional diseases while there is evidence that a low-FODMAP diet could be the first option.

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“…Generally, anaerobic strength exercise has higher adverse effects than aerobic endurance exercise [37,39]. Vigorous exercise, such as competitive running, can impair brain-gut axis signaling, trigger splanchnic ischemia and blood hypoperfusion where blood is moved forward the working muscles, exacerbating nutrient absorption, increasing intestinal permeability and motility dysfunction, and aggravating the severity of IBS GI and extra-GI symptoms [68][69][70][82][83][84][85][86]. Running works against the organized structure of the intestinal tract inside the abdominal cavity by gravity force which may lead to diaphragm spasm, dysbiosis, an increase of serotonin production, affects pain sensitization of afferent nerves, and induce IBS symptoms [85,89].…”

Section: How Substantial Is the Evidence Linking Exercise And Irritab...mentioning

confidence: 99%

“…Scientists may still hesitate to prescribe specific exercises for IBS management due to the lack of accurate indicators of the most appropriate suggestions to give patients [86]. Proper and correct exercise intervention based on the sympathetic and parasympathetic reactivity and tone phenotypes is crucially recommended to obtain the beneficial effect of exercise on IBS symptoms and psychic status, like mood [78,76,81].…”

Section: The Fitt-vp Principle and Irritable Bowel Syndromementioning

confidence: 99%

Can physical exercise help people with irritable bowel syndrome? How substantial is the evidence?

Ahmad,

Thnaibat

2023

HSR

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Purpose: Irritable bowel syndrome is one of the most common gastrointestinal disorders worldwide that negatively affect health and quality of life and imposes high costs. Increasing attention is being paid to non-pharmacological therapies, like physical exercise, to manage and alleviate irritable bowel syndrome symptoms, but the underlying mechanism is unclear, and the evidence is inconclusive. This article aims to provide an overview analysis of the recent evidence that links physical exercise with irritable bowel symptoms. Material and methods. For the last five years of research (2018-2023), we searched several international scientific databases, including Web of Science, Scopus, Science Direct, ADI, the Cochrane Central Register of Controlled Trials, PubMed, Medline, Clinical trials.gov, Google Scholar, and the WHO database. Results. Generally, exercise exerts variable effects on gut physiology, integrity, and health. Much research recommended adopting regular light-to-moderate aerobic exercise and relaxation anaerobic exercise to enhance the patient’s psychological well-being and alleviate global irritable bowel syndrome symptoms. These types of exercise are purported to improve bowel function, motility, tone, habits, immunity, microbial diversity, and quality of life due to a decrease in psychological stress, depression, anxiety index, irritable bowel syndrome symptom severity score, intestinal hypersensitivity, and gut permeability. In contrast, more studies reported several disruptive effects of vigorous aerobic exercise on gut integrity and physiology that can compromise irritable bowel syndrome symptoms by inducing splanchnic hypoperfusion, gastrointestinal epithelial wall damage, malabsorption, dysbiosis, and bacterial translocation, thus calling into question the positive outcomes of the exercise. Conclusions. There is overwhelming evidence recommending regular light-to-moderate aerobic exercise and anaerobic relaxation exercises for patients with IBS. However, this evidence seems low-quality, making it challenging to confirm the actual impacts of exercise. Ethnicity, study design, type and intensity of exercise, and methodological issues are among the reasons that are put forward to account for this low-quality evidence. Thus, well-designed plausible studies, particularly randomized controlled trials and research on individualized exercise intervention settings that consider exercise frequency, intensity, time, type, volume, and progression, are highly demanded to enable drawing specific exercise recommendations for irritable bowel syndrome patients without adverse effects.

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A practical guide to the proper prescription of physical activity in patients with irritable bowel syndrome

Cited by 6 publications

References 10 publications

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Indian consensus statements on irritable bowel syndrome in adults: A guideline by the Indian Neurogastroenterology and Motility Association and jointly supported by the Indian Society of Gastroenterology

Diagnostic management of patients reporting symptoms after wheat ingestion

Can physical exercise help people with irritable bowel syndrome? How substantial is the evidence?

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