Exercise as a complementary therapy in symptom alleviation of irritable bowel syndrome

Abstract

Background: Irritable bowel syndrome (IBS) is a chronic condition that affects 11% of the global population. It is characterised by abdominal pain, bloating, diarrhoea and/or constipation, making it a functional gastrointestinal (GI) disease (Weaver et al., 2017). Recent studies have shown that the presence of a brain-gut axis exist, making it more feasible to manage the symptoms (Kennedy et al., 2014). However, since the pathophysiology of IBS is still not understood, there is no direct treatment. The scope of this dissertation is to examine exercise therapy as a method to alleviate the symptoms non-pharmacologically. From these analyses, the PICO question was formulated: “Does exercise as a complementary therapy improve symptoms of patients suffering from irritable bowel syndrome?”. Method: Numerous databases were searched using keywords that were obtained from Medical Subject Headings (MeSH) browser and numerous online thesauruses. From the search, several hits were obtained which were then followed by an inclusion and exclusion criteria. The identified articles included participants of all ages that were diagnosed with IBS using the Rome criteria, that were able to perform physical exercise without restriction compared to participants receiving usual medical care. The articles were also filtered using the Preferred Reporting Items for Systematic Review and Meta analyses (PRISMA) checklist. In total, three randomised controlled trials (RCTs) and two systematic reviews were obtained, which were analysed using the Critical Appraisal Skill Programme (CASP) tool. Results: The results from this analysis confirmed that physical exercise as a complementary therapy to standard medical care alleviated the symptoms of IBS, however, the quality of life (QOL) was not improved in these participants. Implications and Recommendations: Research conducted in this sector is very poor, showing a substantial need for further research to increase awareness regarding remedial therapies which are ideally cost-effective and target the disease specifically. The use of a multidisciplinary team, such as a gastroenterologist together with physiotherapists could enhance patient care.