Have you ever noticed the urge to have a bowel movement after you have just gone on a long walk? Or perhaps you have noticed your digestive motility seems more regular when you have been getting more exercise?
Well there’s actually some research behind this. Let’s explore!
My curiosity regarding this topic stems partially from this winter’s record snowfall in Portland, OR. The big storm hit us with 12+ inches of snow in hilly regions. It caused treacherous driving conditions that only those with all-wheel-drive and chains seemed to be braving.
That meant there was lots more walking going on. During the storm, my dad and I were averaging about 4-5 miles of walking per day (up & down hills!). And we felt great!
All the exercise we were getting made me ponder whether there was any research showing it could help individuals suffering from constipation.
Research on Exercise & Constipation/Motility
Research has shown that in healthy adults, exercise can improve fatigue, bloating, and constipation.
Studies have also shown an association between lack of physical activity and constipation– although this is epidemiological research, not cause & effect.
And fun fact of the day- walking can help increase bowel emptying in preparation for colonoscopy.
But I also know that the bodies of those with irritable bowel syndrome (IBS) don’t always respond in the same way as those of “healthy adults.” For example, if you tell someone with IBS to go eat a bunch of broccoli and cauliflower, they probably aren’t going to feel so good. But healthy individuals will probably feel great! So I made sure to include a study specific to IBS.
Although the research on exercise and constipation is a bit limited, I found two studies examining the topic as it relates to irritable bowel syndrome (study 1) and chronic constipation (study 2). Let’s take a look.
Study 1: The Effects of Exercise upon Symptoms and Quality of Life in Patients Diagnosed with Irritable Bowel Syndrome: A Randomised Controlled Trial
This study included 56 individuals ages 18-65 years old. They had received an IBS diagnosis within the previous year.
None of the participants already engaged in regular physical activity (defined as 30 minutes, 3+ times per week, for at least 3 months). And none of the participants had been diagnosed with other major illnesses that would significantly influence quality of life or explain their symptoms.
The participants were assigned to one of two groups: “exercise intervention” or “usual care.”
The 28 subjects who participated in the exercise intervention received two 40-minute exercise consultations over a 12-week period. They were encouraged to slowly work up to 30 minutes of moderate-intensity exercise five times per week.
Walking was especially encouraged and participants received a pedometer to help monitor their progress. They also received postcards in the mail as further encouragement.
There were 28 individuals who were randomly assigned to receive “usual care.” It is unclear from the article whether the usual care group received any advice or treatment. However, they were asked to not change their exercise pattern during the study. This means that they did not engage in regular physical activity (defined as 30 minutes, 3+ times per week).
The promising news is this: “the exercise group reported significantly improved symptoms of constipation.” That’s right- physical activity can help with constipation!
Unfortunately, quality of life did not differ between the two groups.
Study 2: Effects of Regular Physical Activity on Defecation Pattern in Middle-Aged Patients Complaining of Chronic Constipation
The second study focused on individuals with chronic constipation who did not have IBS. They also did not have any GI diseases or previous GI surgeries. And they could not be using medications (except laxatives) that might impact bowel movements.
The 43 participants who completed this study were sedentary individuals ages 45+. Sedentary was defined as less than 30+ mins of moderate physical activity on most days of the week.
The subjects were suffering from any of the following for at least 12 weeks (not necessarily consecutive) in the previous year:
- Straining at least 25 percent of the time
- Lumpy or hard stools at least 25 percent of the time
- Sensation of incomplete bowel movement at least 25 percent of the time
- Less than 3 bowel movements per week
The participants were divided into Group A and Group B. Only Group B received the physical activity intervention in the first 12 weeks.
The intervention included two 30-minute walks per week at 70-80% of the participants’ maximum heart rate. One walk was supervised every two weeks to help participants determine their ideal pace.
It also included a daily 11-minute strength and flexibility component. It was similar to this program: “Canadian Airforce Program for Physical Fitness.”
Participants recorded their bowel movements in a poop journal for 7 days before starting the physical activity intervention and then for 7 days after. They could not use laxatives within 3 days prior to the beginning of journaling.
The exercise intervention group saw improvements in the following:
- Decreased straining
- Fewer hard/lumpy stools
- Decrease in incomplete bowel movements
The one result that did not change significantly was the overall number of stools.
These articles show that exercise is a promising and low-risk way to improve symptoms of IBS-C and chronic constipation.
But I find that people often have difficulty adopting lifestyle changes unless they understand the “WHY?”
So WHY would physical activity help with constipation?
- Increased gastrointestinal motility– AKA speeds up the passage of food/waste through the digestive tract
- Stress reduction– which helps shift the body to a “rest & digest”, rather than “fight or flight” state
- Neuroimmuno-endocrine alterations– (neuro->nervous system; immuno-> immune system; endocrine-> hormones)- these systems work together in a complex manner and it is believed that exercise can influence them in a positive way, supporting healthy motility
Have you noticed exercise impacting your motility? Please share!
 Daley AJ, Grimmett C, Roberts L, et al. The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial. Int J Sports Med. 2008;29(9):778-82.
 De schryver AM, Keulemans YC, Peters HP, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol. 2005;40(4):422-9.
I wonder what do you think about the idea that sibo bacteria actually help you – i mean they ferment food that otherwise will destroy your gut if if remains undigested and that the gas bacteria produce is not the problem?
I mean here we have the same story like cholesterol scam – this time the idea is to sell antibiotics. I wonder if motility is actually a problem with sibo or the bigger problem is lack of digestive enzymes. Because the body have several mechanisms to clean the bowels – HCl, bicarbonate from pancreas and SigA. Also some people seems to get worse from antimicrobials. I read many times in forums how people cure their sibo with high carb diets like 80-10-10 or starch solution instead of low carb diets and the only explanation i see is that enzymes are more important than motility.
Not sure I follow your argument for SIBO bacteria being helpful- what makes you say that the food would destroy your gut if it remained undigested? Are you referring to leaky gut?
I really do not feel it is a scam. I think that there are practitioners who take advantage of patients, but I think the majority have the patient’s best interest at heart.
Personally, motility agents have helped me greatly while digestive enzymes, HCL do very little in terms of symptomatic relief for me.
I do not see high carb diets being appropriate for the majority of individuals who come to see me with SIBO. Perhaps those who claim it have helped them have trouble digesting fats and/or protein and therefore feel better with more carbohydrates. My approach is all about balance.