Exercise and IBS-D

I love to run. Well, to be honest, I love to jog. Every morning I put on my shoes and head out the door just as the sun is coming up. Most mornings I keep up a leisurely 10-minute mile pace, unless my IBS-D flares up. When that happens, I look like Usain Bolt sprinting for the nearest public restroom. After a particularly close call involving a locked bathroom in the park, my husband asked why I keep it up.

Even though I take a daily probiotic, steer clear of my trigger foods and take IBS/W daily to help alleviate my IBS symptoms, exercise still occasionally leads to bouts of diarrhea. Core workouts, which target my abdominal walls, put pressure on my stomach and intestines. Aerobic workouts, such as running and step classes, can be very jarring. Every time my foot hits the pavement, my organs, especially my stomach and intestines, are getting bounced around. All of that pounding can occasionally make my symptoms worse.

Given the possibility of a very embarrassing incident, should women with IBS-D continue to exercise regularly? Absolutely. Exercise is good for everyone. It can elevate mood, improve sleep, strengthen bones and improve heart function. 

Exercise is also a great stress reducer. Lowering stress levels is always a good thing, but IBS patients will benefit since there is a documented relationship between psychosocial stress and IBS. Less stress means fewer IBS symptoms.

In addition, recent studies show that IBS is caused by some sort of dysbiosis, or imbalance, in the gut. Science is discovering that, regardless of diet, people who exercise have a more diverse microbiome than those who are sedentary. So exercise should help anyone who suffers from IBS. However, people with IBS-D suffer a greater loss of bacterial diversity in comparison with individuals with IBS-C and people without IBS. That loss correlates with the bacteria responsible for producing butyrate and methane. New studies show that exercise may actually enhance butyrate-producing cecal bacteria. This means that exercise may be particularly good for patients with IBS-D because it helps replace the good bacteria that they lose through diarrhea.

If you want to add exercise into your daily routine but you are still terrified that diarrhea will strike at an inopportune time, here are a few suggestions.

  1. Don’t eat anything for two hours before exercise.
  2. Avoid caffeinated and carbonated drinks before exercise.
  3. Stay hydrated. Both exercise and bouts of diarrhea can leave you dehydrated. By the time that you realize that you are thirsty, it may be too late to catch up.
  4. Check in with your body. If you are tired or having an IBS flare, avoid strenuous or intense workouts. Stick with low-impact exercises, such as Pilates, yoga, walking or swimming.
  5. Plan your route. If you are going out for a run or a long bike ride, know where the public restrooms are and stash some tissue in your pocket.
  6. If you really don’t feel good, take a day off and give your body a rest.

Remember that exercise is about taking care of your body, not punishing it. Take it slow and easy, and you may find that your IBS-D symptoms improve along with your mood, weight and sleep.