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Evaluation of the effectiveness of exercise therapy for irritable bowel syndrome: a systematic review and
Jiali Wu1,2, Shaojie Du1,3, Yanting Sun1,4
1Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Objective:
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain, distension, and altered bowel habits that significantly impacts patients' quality of life and imposes a substantial socioeconomic burden. Traditional treatment options, including antispasmodics and probiotics, are often limited by modest efficacy, variable evidence quality, and challenges with long-term adherence, highlighting the need for alternative non-pharmacological strategies. Exercise has gained attention as a non-pharmacological intervention because of its ability to regulate autonomic function and modulate inflammatory pathways. In this review, we define exercise therapy as a planned, structured, and repetitive physical activity program with specified type, frequency, intensity, and duration.
Methods:
The PubMed, Embase, Web of Science, and Ovid databases were searched up to February 17, 2025 for studies that compared exercise therapy with no exercise therapy in IBS. A meta-analysis was conducted, and when heterogeneity was excessive, a sensitivity analysis was performed.
Results:
Of 2,142 citations screened, 10 studies that included 437 patients with IBS were selected. The meta-analysis indicated that improvement in the IBS-SSS score was greater in the exercise group IBS than in the control group. However, the effects of exercise intervention on the IBS-QOL measure and anxiety were not statistically significant.
Conclusion:
Exercise interventions could alleviate symptoms in patients with IBS, although their impact on quality of life scores and remission of anxiety is unclear. There is no evidence-based consensus on a standardized exercise prescription for IBS. The absence of such a framework may introduce potential confounders, affecting the accuracy of efficacy assessments of quality of life and psychological outcomes. Multicenter randomized controlled trials with a standardized exercise framework are needed to explore the role and mechanisms of exercise therapy in management of IBS.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420250478248, identifier PROSPERO (CRD420250478248).
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