Irritable Bowel Syndrome, or IBS, is the most commonly diagnosed gastrointestinal disorder. IBS symptoms include, but are not limited to, bloating, constipation, nausea, abdominal pain, and diarrhea. Severity of symptoms vary from person to person but can be managed or slightly controlled through nutrition and exercise practices (Nutrition Care Manual, 2020).
When it comes to nutrition, current literature supports a focus on foods that are low in fermentable oligo-di- and mono-saccharides and polyols, or the FODMAP diet (Wilkins et al., 2012; Ong et al., 2010). The FODMAP list of foods can be found here and should be approached slowly, eliminating high FODMAP sources one at a time, while tracking changes in IBS symptoms. It is also recommended to avoid foods high in fructose and foods that contain sugar alcohols such as sorbitol, mannitol and xylitol, as they may worsen gas and bloating (Heizer et al., 2009). It may also be beneficial to focus on small, frequent meals throughout the day in order to minimize nausea, gas and bloating after meals (Kellow et al., 1987).
Exercise has also been shown to improve IBS symptoms (Johannesson et al., 2011). One study demonstrated that working up to 30 minutes of moderate intensity exercise (40-60% max heart rate), five days per week helped alleviate discomfort (Daley et al., 2008). In a group of middle aged women, it was also shown that low-to-moderate aerobic exercise reduced symptoms and improved associated pro-inflammatory cytokines commonly seen in patients with IBS. Participants performed moderate intensity walking and/or jogging for 30 minutes, three to four times per week (Maleki et al., 2018).
Resistance training is proven to help increase muscular strength, lean body mass, inflammatory markers, and IBS symptoms as well, and may be an essential form of exercise for IBS patients that have persistent symptoms with aerobic exercise (Tajiri et al., 2014). More research is needed to establish specific exercise recommendations specific to individuals with IBS.
References
Academy of Nutrition and Dietetics. Nutrition Care Manual. http://www.nutritioncaremanual.org. Accessed 2020 July 17.
Daley, A. J., Grimmett, C., Roberts, L., Wilson, S., Fatek, M., Roalfe, A., & Singh, S. (2008). The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial. International journal of sports medicine, 29(9), 778.
de Souza Tajiri, G. J., de Castro, C. L. N., & Zaltman, C. (2014). Progressive resistance training improves muscle strength in women with inflammatory bowel disease and quadriceps weakness. Journal of Crohn’s and Colitis, 8(12), 1749-1750.
Heizer, W. D., Southern, S., & McGovern, S. (2009). The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. Journal of the American Dietetic Association, 109(7), 1204-1214.
Johannesson, E., Simrén, M., Strid, H., Bajor, A., & Sadik, R. (2011). Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology, 106(5), 915-922.
Kellow, J. E., & Phillips, S. F. (1987). Altered small bowel motility in irritable bowel syndrome is correlated with symptoms. Gastroenterology, 92(6), 1885-1893.
Maleki, B. H., Tartibian, B., Mooren, F. C., FitzGerald, L. Z., Krüger, K., Chehrazi, M., & Malandish, A. (2018). 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, 102, 18-25.
Ong, D. K., Mitchell, S. B., Barrett, J. S., Shepherd, S. J., Irving, P. M., Biesiekierski, J. R., … & Muir, J. G. (2010). Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. Journal of gastroenterology and hepatology, 25(8), 1366-1373.
Wilkins, T., Pepitone, C., Alex, B., & Schade, R. R. (2012). Diagnosis and management of IBS in adults. American family physician, 86(5), 419-426.
