The Effects of Exercise upon Symptoms and Quality of Life in Patients Diagnosed with Irritable Bowel Syndrome: A Randomised Controlled Trial

 

 Buy Article Permissions and Reprints

Abstract

While it seems intuitively appealing to promote participation in regular exercise in the management of irritable bowel syndrome, limited randomised controlled trial evidence exists to support this recommendation. We examined the feasibility and effects of an exercise intervention upon quality of life and irritable bowel symptoms using a randomised controlled trial methodology. Patients with a clinically confirmed diagnosis of irritable bowel syndrome according to Rome II criteria were randomised to either an exercise consultation intervention or usual care for 12 weeks. Outcomes included irritable bowel specific quality of life, symptoms (total symptoms, constipation, diarrhoea and pain) and exercise participation. The recruitment rate of eligible patients identified from hospital records was 18.3 % (56/305). Analyses revealed no differences in quality life scores between groups at 12-week follow-up. The exercise group reported significantly improved symptoms of constipation (mean difference = 10.9, 95 % CI = − 20.1, − 1.6) compared to usual care at follow-up. The intervention group participated in significantly more exercise than usual care at follow-up (mean difference = 21.6, 95 % CI = 9.4, 33.8). Recruitment of eligible patients into this study was possible but rates were low. Findings highlight the possibility that exercise may be an effective intervention for symptom management in patients with irritable bowel syndrome; this may be particularly the case for constipation predominant patients.

References

• 1 Cohen S, Kamarck T, Mermelsstein R A. A global measure of perceived stress.  J Health Social Behav. 1983;  24 386-396
  PubMedGoogle Scholar
• 2 Colwell L J, Prather C M, Phillips S F, Zinsmeister A R. Effects of an irritable bowel syndrome educational class on health-promoting behaviours and symptoms.  Am J Gastroenterol. 1998;  93 901-905
  CrossrefPubMedGoogle Scholar
• 3 Department of Health .At least five a week: Evidence on the impact of physical activity and its relationship to health, 2004. www.dh.gov.uk. Date accessed 11/01/06. 
  Google Scholar
• 4 Donald I P, Smith R G, Cruikshank J G, Elton P A, Stoddart M E. A study of constipation in the elderly living at home.  Gerontology. 1985;  31 112-118
  CrossrefPubMedGoogle Scholar
• 5 Drossman D, Corazziari E, Talley N J, Thompson W G, Whitehead W E. Rome II: The functional gastrointestinal disorders: diagnosis pathophysiology and treatment: a multinational consensus. McLean, VA; Degnon Associates 2000: 351-432
  Google Scholar
• 6 Everhart J E, Go V L, Johannes R S, Fitzsimmons S C, Roth H P, White L R. A longitudinal survey of self-reported bowel habits in the United States.  Dig Dis Sci. 1989;  34 1153-1162
  CrossrefPubMedGoogle Scholar
• 7 Godin G, Shephard R J. A simple method to assess exercise behaviour in the community.  Can J Appl Sports Sci. 1985;  10 141-146
  PubMedGoogle Scholar
• 8 Hungin A P, Whorwell P J, Tack J, Mearin F. The prevalence, patterns and impact of irritable bowel syndrome: An international survey of 40 000 subjects.  Aliment Pharmacol Ther. 2003;  17 643-650
  CrossrefPubMedGoogle Scholar
• 9 Jones J, Boorman J, Cann P, Forbes A, Gomborone J, Heaton K, Hungin P, Kumar D, Libby G, Spiller R, Read N, Silk D, Whorwell. British Society of Gastroenterology guidelines for the management of the irritable bowel syndrome.  Gut. 2000;  47 ii1-iii19
  CrossrefPubMedGoogle Scholar
• 10 Jones R, Lydeard S. Irritable bowel syndrome in the general population.  BMJ. 1992;  304 87-90
  CrossrefPubMedGoogle Scholar
• 11 Keeling W F, Harris A, Martin B J. Orocecal transit during mild exercise in women.  J Appl Physiol. 1990;  68 1350-1353
  CrossrefPubMedGoogle Scholar
• 12 Kim H S, Park D H, Kim J W, Jee M G, Baik S K, Kwon S O, Lee D K. Effectiveness of walking exercise as a bowel preparation for colonoscopy: A randomised controlled trial.  Am J Gastroenterol. 2005;  100 1964-1969
  CrossrefPubMedGoogle Scholar
• 13 Kinnunen O. Study of constipation in a geriatric hospital, day hospital, old people's home and at home.  Aging. 1991;  3 161-170
  PubMedGoogle Scholar
• 14 Kirk A, Mutrie N, MacIntyre P, Fisher M. Increasing physical activity in people with type 2 diabetes.  Diabetes Care. 2003;  26 1186-1192
  CrossrefPubMedGoogle Scholar
• 15 Klauser A G, Peyerl C, Schindlbeck N E. Nutrition and physical activity in chronic constipation.  Eur J Gastroenterol Hepatol. 1992;  4 227-233
  PubMedGoogle Scholar
• 16 Koloski N A, Talley N J, Huskic S S, Boyce P M. Predictors of conventional and alternative health care seeking for irritable bowel syndrome and functional dyspepsia.  Aliment Pharmacol Ther. 2003;  17 841-851
  CrossrefPubMedGoogle Scholar
• 17 Loudon C P, Correll V, Butcher J, Rawsthorne P, Bernstein C N. The effects of physical exercise on patients with Crohn's disease.  Am J Gastroenterol. 1999;  94 697-703
  CrossrefPubMedGoogle Scholar
• 18 Lowther M, Mutrie N, Scott E M. Promoting physical activity in a socially and economically deprived community: a 12-month randomised control trial of a fitness assessment and exercise consultation.  J Sports Sci. 2002;  20 577-588
  CrossrefPubMedGoogle Scholar
• 19 Maxton D G, Morris J, Whorwell P. Improving clinical trials in irritable bowel syndrome: Some practical aspects.  Eur J Gastroenterol Hepatol. 1992;  4 337-341
  PubMedGoogle Scholar
• 20 Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A. Effects of regular exercise in the management of chronic idiopathic constipation.  Dig Dis Sci. 1998;  43 2379-2383
  CrossrefPubMedGoogle Scholar
• 21 Oettle G J. Effects of moderate exercise on bowel habit.  Gut. 1991;  32 941-944
  CrossrefPubMedGoogle Scholar
• 22 Office of the Deputy Prime Minister (OPDM) .The English Indices of Deprivation 2004: Summary (revised). ODPM, United Kingdom. www.communities.gov.uk/pub/443/Indicesofdeprivation2004summaryrevisedPDF154Kb_id1128443.pdf. Date accessed 15 February 2006. 
  Google Scholar
• 23 Patrick D L, Drossman D A, Frederick I O, DiCesare J, Puder K L. Quality of life in persons with irritable bowel syndrome: Development of a new measure.  Dig Dis Sci. 1998;  43 400-411
  CrossrefPubMedGoogle Scholar
• 24 Peters H P, De Vries W R, Vanberge-Henegouwen G P, Akkermans L M. Potential benefits and hazards of physical activity and exercise on the gastrointestinal tract.  Gut. 2001;  48 435-439
  CrossrefPubMedGoogle Scholar
• 25 Roberts L M, Wilson S, Singh S, Roalfe A K, Greenfield S. Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomised controlled trial.  B J Gen Pract. 2006;  56 115-121
  PubMedGoogle Scholar
• 26 Sullivan S N, Wong C, Heidenheim P. Does running cause gastrointestinal symptoms? A survey of 93 randomly selected runners compared with controls.  N Z Med J. 1994;  107 328-331
  PubMedGoogle Scholar
• 27 Taylor A H. Physical activity, anxiety and stress. Biddle SJH, Fox K, Boutcher SH Physical Activity and Psychological Well-Being. London; Routledge 2000: 10-45
  Google Scholar
• 28 Tuteja A, Talley N, Joos S K, Woehl J V, Hickam D H. Is constipation associated with decreased physical activity in normally active subjects?.  Am J Gastroenterol. 2005;  100 124-129
  CrossrefPubMedGoogle Scholar
• 29 Vickers A J, Altman D G. Analysing controlled trials with baseline and follow up measurements.  BMJ. 2001;  323 1123-1124
  CrossrefPubMedGoogle Scholar
• 30 Wilson S, Roberts L, Roalfe A, Bridge P, Singh S. Prevalence of irritable bowel syndrome: A community survey.  B J Gen Pract. 2004;  54 495-502
  PubMedGoogle Scholar

Dr. Amanda J. Daley

University of Birmingham
Primary Care and General Practice

Clinical Sciences Building, Edgbaston

B15 2TT Birmingham

United Kingdom

Phone: + 0 12 14 14 37 62

Fax: + 0 12 14 14 37 62

Email: a.daley@bham.ac.uk