Clinical management of constipation – the role of physical activity - systematic review
DOI:
https://doi.org/10.12775/QS.2024.31.55135Keywords
CONSTIPATION, SPORT, PHYSICAL ACTIVITYAbstract
Constipation is a prevalent gastrointestinal disorder that affects a significant portion of the global population, yet its management remains challenging due to its complex etiology. This review explores the potential benefits and mechanisms of physical activity in alleviating constipation symptoms. We examined recent studies on the physiological effects of various exercise types and intensities on bowel movements, gastrointestinal blood flow, and microbiome composition. Our findings suggest that aerobic exercise enhances colonic motility and accelerates gastrointestinal transit, though the effects vary depending on exercise duration and intensity. While light to moderate physical activity (less than 60 minutes) appears beneficial, prolonged or intense exercise may inhibit motility and exacerbate symptoms. Additionally, exercise-induced changes in the gut microbiome and blood flow dynamics were observed, influencing stool consistency and colonic function. However, the interplay between diet, hydration, and physical activity is crucial, as adequate dietary fiber and hydration are essential for optimizing exercise's impact on constipation. Although evidence supports the role of physical activity in managing constipation, further research is needed to clarify the most effective exercise regimens and their integration with dietary and lifestyle modifications.
References
Gao R, Tao Y, Zhou C, et al. Exercise Therapy in Patients with constipation: a Systematic Review and meta-analysis of Randomized Controlled Trials. Scandinavian Journal of Gastroenterology. 2019;54(2):169-177. doi:https://doi.org/10.1080/00365521.2019.1568544 2. Chu H, Zhong L, Li H, Zhang X, Zhang J, Hou X. Epidemiology Characteristics of Constipation for General Population, Pediatric Population, and Elderly Population in China. Gastroenterology Research and Practice. 2014;2014:1-11. doi:https://doi.org/10.1155/2014/532734 3. Lacy BE, Mearin F, Chang L, et al. Bowel Disorders. Gastroenterology. 2016;150(6):1393-1407.e5. doi:https://doi.org/10.1053/j.gastro.2016.02.031
Kim SJ. Diet, Physical Activity, and Chronic Constipation: Unveiling the Combined Effects for Better Treatment Strategies. Journal of Neurogastroenterology and Motility. 2024;30(3):255-256. doi:https://doi.org/10.5056/jnm24085
Belsey J, Greenfield S, Candy D, Geraint M. Systematic review: impact of constipation on quality of life in adults and children. Alimentary Pharmacology & Therapeutics. 2010;31(9). doi:https://doi.org/10.1111/j.1365-2036.2010.04273.x
Heidelbaugh JJ, Stelwagon M, Miller SA, Shea EP, Chey WD. The Spectrum of Constipation-Predominant Irritable Bowel Syndrome and Chronic Idiopathic Constipation: US Survey Assessing Symptoms, Care Seeking, and Disease Burden. American Journal of Gastroenterology. 2015;110(4):580-587. doi:https://doi.org/10.1038/ajg.2015.67
Thomas RH, Luthin DR. Current and Emerging Treatments for Irritable Bowel Syndrome with Constipation and Chronic Idiopathic Constipation: Focus on Prosecretory Agents. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2015;35(6):613-630. doi:https://doi.org/10.1002/phar.1594
Kuizenga-Wessel S, Koppen IJN, Zwager LW, Di Lorenzo C, de Jong JR, Benninga MA. Surgical management of children with intractable functional constipation; experience of a single tertiary children’s hospital. Neurogastroenterology & Motility. 2016;29(5):e13005. doi:https://doi.org/10.1111/nmo.13005
Christodoulides S, Dimidi E, Fragkos KC, Farmer AD, Whelan K, Scott SM. Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults. Alimentary Pharmacology & Therapeutics. 2016;44(2):103-116. doi:https://doi.org/10.1111/apt.13662
Oettle GJ. Effect of moderate exercise on bowel habit. Gut. 1991;32(8):941-944. doi:https://doi.org/10.1136/gut.32.8.941
Hughes RL, Holscher HD. Fueling Gut Microbes: A Review of the Interaction between Diet, Exercise, and the Gut Microbiota in Athletes. Advances in Nutrition (Bethesda, Md). 2021;12(6):nmab077. doi:https://doi.org/10.1093/advances/nmab077
Costa RJS, Snipe RMJ, Kitic CM, Gibson PR. Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Alimentary Pharmacology & Therapeutics. 2017;46(3):246-265. doi:https://doi.org/10.1111/apt.14157
Koffler KH, Menkes A, Redmond RA, Whitehead WE, Pratley RE, Hurley BF. Strength training accelerates gastrointestinal transit in middle-aged and older men. Medicine and Science in Sports and Exercise. 1992;24(4):415???419-415???419. doi:https://doi.org/10.1249/00005768-199204000-00004
Bingham SA, Cummings JH. Effect of exercise and physical fitness on large intestinal function. Gastroenterology. 1989;97(6):1389-1399. doi:https://doi.org/10.1016/0016-5085(89)90381-8
Dainese R, Serra J, Azpiroz F, Malagelada Juan-R. Effects of physical activity on intestinal gas transit and evacuation in healthy subjects. The American Journal of Medicine. 2004;116(8):536-539. doi:https://doi.org/10.1016/j.amjmed.2003.12.018
Villoria A, Serra J, Azpiroz F, Malagelada Juan-R. Physical activity and intestinal gas clearance in patients with bloating. The American Journal of Gastroenterology. 2006;101(11):2552-2557. doi:https://doi.org/10.1111/j.1572-0241.2006.00873.x
Chey WD, Rai J. Exercise and IBS: No Pain, No Gain. Gastroenterology. 2011;141(5):1941-1943. doi:https://doi.org/10.1053/j.gastro.2011.09.030
Neufer PD, Young AJ, Sawka MN. Gastric emptying during walking and running: effects of varied exercise intensity. European Journal of Applied Physiology and Occupational Physiology. 1989;58(4):440-445. doi:https://doi.org/10.1007/BF00643522
Strid H, Simrén M, Störsrud S, Stotzer PO, Sadik R. Effect of heavy exercise on gastrointestinal transit in endurance athletes. Scandinavian Journal of Gastroenterology. 2011;46(6):673-677. doi:https://doi.org/10.3109/00365521.2011.558110
Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical Activity Improves Symptoms in Irritable Bowel Syndrome: A Randomized Controlled Trial. The American Journal of Gastroenterology. 2011;106(5):915-922. doi:https://doi.org/10.1038/ajg.2010.480
Østgaard H, Hausken T, Gundersen D, El-Salhy M. Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome. Molecular Medicine Reports. March 2012. doi:https://doi.org/10.3892/mmr.2012.843
Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: A systematic review. Best Practice & Research Clinical Gastroenterology. 2011;25(1):3-18. doi:https://doi.org/10.1016/j.bpg.2010.12.010
Smith TK, Park KJ, Hennig GW. Colonic migrating motor complexes, high amplitude propagating contractions, neural reflexes and the importance of neuronal and mucosal serotonin. Journal of Neurogastroenterology and Motility. 2014;20(4):423-446. doi:https://doi.org/10.5056/jnm14092
Bull FC, Al-Ansari SS, Biddle S, et al. World health organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine. 2020;54(24):1451-1462. doi:https://doi.org/10.1136/bjsports-2020-102955
Rowell LB, Blackmon JR, Bruce RA. Indocyanine Green Clearance and Estimated Hepatic Blood Flow during Mild to Maximal Exercise in Upright Man *. Journal of Clinical Investigation. 1964;43(8):1677-1690. doi:https://doi.org/10.1172/jci105043
Driessen LM, Jong JCK, Wijtzes A, et al. Preschool Physical Activity and Functional Constipation. Journal of Pediatric Gastroenterology and Nutrition. 2013;57(6):768-774. doi:https://doi.org/10.1097/mpg.0b013e3182a313fc
Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. The American Journal of Gastroenterology. 2003;98(8):1790-1796. doi:https://doi.org/10.1111/j.1572-0241.2003.07591.x
Vargas-García EJ, Vargas-Salado E. [Food intake, nutritional status and physical activity between elderly with and without chronic constipation. A comparative study]. PubMed. 2013;81(3):214-220. https://pubmed.ncbi.nlm.nih.gov/23769250.
Zhou C, Zhao E, Li Y, Jia Y, Li F. Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society. 2019;31(2):e13461. doi:https://doi.org/10.1111/nmo.13461
Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM. Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2017;10(10):513-519. doi:https://doi.org/10.2147/DMSO.S140250
Schnelle JF, Leung FW, Rao SSC, et al. A Controlled Trial of an Intervention to Improve Urinary and Fecal Incontinence and Constipation. Journal of the American Geriatrics Society. 2010;58(8):1504-1511. doi:https://doi.org/10.1111/j.1532-5415.2010.02978.x
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. Scandinavian Journal of Gastroenterology. 2005;40(4):422-429. doi:https://doi.org/10.1080/00365520510011641
Shiro Y, Arai YC, Ikemoto T, Hayashi K. Stool consistency is significantly associated with pain perception. Green J, ed. PLOS ONE. 2017;12(8):e0182859. doi:https://doi.org/10.1371/journal.pone.0182859
Gaskell SK, Rauch CE, Parr A, Costa RJS. Diurnal versus Nocturnal Exercise—Impact on the Gastrointestinal Tract. Medicine & Science in Sports & Exercise. 2020;Publish Ahead of Print. doi:https://doi.org/10.1249/mss.0000000000002546
Brouns F, Beckers E. Is the Gut an Athletic Organ? Sports Medicine. 1993;15(4):242-257. doi:https://doi.org/10.2165/00007256-199315040-00003
Black CJ, Ford AC. Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management. Medical Journal of Australia. 2018;209(2):86-91. doi:https://doi.org/10.5694/mja18.00241
Simoes GD, De Araujo Martins F, Capistrano VLM Jr, Loureiro LL, De Souza MLR. Sleep quality in CrossFit: a Cross-Sectional study. Sleep Science. 2024;17(01):e16-e25. doi:https://doi.org/10.1055/s-0043-1778014
Bycura D, Santos AC, Shiffer A, et al. Impact of different exercise modalities on the human gut microbiome. Sports. 2021;9(2):14. doi:https://doi.org/10.3390/sports9020014
Triantafyllou K, Chang C, Pimentel M. Methanogens, methane and gastrointestinal motility. Journal of Neurogastroenterology and Motility. 2014;20(1):31-40. doi:https://doi.org/10.5056/jnm.2014.20.1.31
Parthasarathy G, Chen J, Chen X, et al. Relationship Between Microbiota of the Colonic Mucosa vs Feces and Symptoms, Colonic Transit, and Methane Production in Female Patients With Chronic Constipation. Gastroenterology. 2016;150(2):367-379.e1. doi:https://doi.org/10.1053/j.gastro.2015.10.005
Son J, Jang LG, Kim BY, Lee S, Park H. The effect of athletes’ probiotic intake may depend on protein and dietary fiber intake. Nutrients. 2020;12(10):2947. doi:https://doi.org/10.3390/nu12102947
Wald A, Van Thiel DH, Hoechstetter L, et al. Gastrointestinal transit: The effect of the menstrual cycle. Gastroenterology. 1981;80(6):1497-1500. doi:https://doi.org/10.1016/0016-5085(81)90263-8
Campbell KG, Batt ME, Drummond A. Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey. International Urogynecology Journal. 2023;34(10):2429-2437. doi:https://doi.org/10.1007/s00192-023-05548-8
I Xinias, A Mavroudi. Constipation in Childhood. An update on evaluation and management. PubMed. 2015;19(1):11-19. https://pubmed.ncbi.nlm.nih.gov/26435640.
Leung AK, Hon KL. Paediatrics: how to manage functional constipation. Drugs in Context. 2021;10:1-14. doi:https://doi.org/10.7573/dic.2020-11-2
Tabbers MM, DiLorenzo C, Berger MY, et al. Evaluation and treatment of functional constipation in infants and children. Journal of Pediatric Gastroenterology and Nutrition. 2014;58(2):258-274. doi:https://doi.org/10.1097/mpg.0000000000000266
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