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

Abstract

<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD420250478248, identifier PROSPERO (CRD420250478248).