Evaluation of the effectiveness of exercise therapy for irritable bowel syndrome: a systematic review and meta-analysis

TL;DR

This study reviews and analyzes the effectiveness of exercise therapy for managing symptoms of irritable bowel syndrome.

Contribution

The paper provides a systematic review and meta-analysis on the role of structured exercise in treating IBS.

Findings

Exercise therapy showed greater improvement in IBS-SSS scores compared to control groups.

No significant effects were found on IBS-QOL or anxiety outcomes.

Standardized exercise prescriptions for IBS are lacking, affecting outcome accuracy.

Abstract

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.

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.

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.

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.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420250478248, identifier PROSPERO (CRD420250478248).

Figures