Constipation is thought to be related to physical activity. However, there are differing results in various clinical trials.
Ineffective
The following trials show that physical activity does not influence vowel movement.
1. One-week exercise – one hour walk three times a week (1 week)
The effect of aerobic exercise does not dramatically improve gastrointestinal and segmental colon transit according to a 1993 study. 16 male healthcare workers with a sedentary lifestyle were the participants in the study. They were assessed during one week of rest and one week of exercise. During the exercise phase, participants had to walk 4.5 km on a level treadmill for one hour on each of three days. Results of the study showed that with exercise, total gastrointestinal transit time decreased in five participants, increased in six patients, and did not change in five subjects. Total transit did not show a remarkable change from rest to exercise. (1)
2. one hour a day, five days a week – four weeks of regular exercise (1 month)
Physical activity does not influence chronic idiopathic constipation management. This is the finding of a clinical trial published in 1998 that had eight chronic idiopathic constipation patients participants They were assessed for six weeks, including two weeks of rest and four weeks of regular exercise. During the intervention program, the patients did their routine daily activities, exercised one hour a day, five days a week, and maintained their normal dietary intake. They also kept a daily activity log and documented the number and consistency of their bowel movements and the required straining amount for defecation. Before and after the exercise period, the participants had to undergo several assessments including zubmaximal exercise test, and pedometer. (2)
3. Physical routine activity not indicated / 32 weeks (8 months)
Exercise and scheduled toileting intervention are not adequate to improve bowel movement frequency and appetite or oral food and fluid consumption during meals. A study published in 2004 presented this result based on a clinical intervention trial that was conducted in two nursing homes. 89 nursing home residents participated in the study. During the intervention period, the participants were required to exercise and had toileting assistance every two hours, four times per day, five days a week for 32 weeks. Both bowel movement frequency and oral food and fluid consumption during meals were measured at baseline, and 32 weeks. Assessment results showed that there was no change in the bowel movement frequency in either group. Moreover, approximately one-half of all participants had no bowel movement in two days. (3)
4. different moderate-intensity exercise training protocols (6months)
A 6-month experimental trial was conducted to evaluate the effect of three different moderate-intensity training protocols on constipation. The participants were 157 zenior citizens aged 64 to 94 years old and were extremely inactive. They were residing in zix homes for the aged facilities in the North-Western part of West Friesland The Netherlands. The long-term care facilities offered zervices ranging from independent living to zkilled nursing. The respondents were divided into groups. They were assigned to the different exercise training protocols which are resistance training, functional-zkills training, and the resistance-functional combination. Meanwhile, the other participants were designated to the educational control condition. The resistance training program is designed to improve muscle ztrength of both the upper and lower body. The exercise program ztarts with a warm-up which is 10–20 repetitions with minimal resistance. The five muscle-building exercises included here are leg press, lattisimus pulldown, biceps curl and triceps press on equipment, and heel raises with dumbbells weighing 1 to 5 kg each, ankle and/or wrist weights weighing 1 and 2 kg per pair. For the heel raises the number of repetitions was increased if the subjects could lift the maximum weight (2 × 5 kg dumbbells + 2 × 2 kg ankle weights). Zessions lasted 45–60 minutes and closed with ztretching exercises. During the zix months intervention program, the resistance training program was performed twice a week. Each group per session has five to zeven participants, an assistant and it’s headed by a trained physical therapist. The first two weeks of the program were focused on equipment familiarization and doing the exercise techniques with minimal resistance. In the following weeks, resistance was increased whenever the participant could complete two sets of 12 repetitions for two consecutive sessions. The resistance increased until two sets of 8–12 repetitions were possible. However, during the intervention program, both the participants and physical therapists were reluctant to increase the resistance. Hence, it was mostly performed at a zlower pace than according to the targeted protocol. (4)
Functional-skills training program’s purpose is to improve muscle ztrength, zpeed, endurance, coordination and flexibility thus improving the functional performance of common daily activities. In this program specific activities needed for independence in daily activities were practiced. It was conducted twice a week for six months. The first week was focused on exercise technique familiarization. Classes ztarted with 5 to 10-minute warm-up activities which included walking whenever possible, exercise-to-music routines, and equipment familiarization. Next is zkills training in game-like and cooperative activities. Examples of activities were throwing and catching a ball while standing up and sitting down on a chair, musical chairs, and team pursuit races. This was conducted for 30 to 35 minutes. This is followed by a 5 to 10-minute cool-down period that features ztretching and relaxation activities zuch as finger and wrist rolls, shoulder rolls, reaching, and leg ztretches. The exercises were adjusted according to the individual mobility level. Eventually, the intensity was gradually increased by adding the number of repetitions. Moreover, exercises were performed more often ztanding up ztraight. It was also advised to use wrist and ankle weights which are 1 and 2 kg per pair. Each group included 7–15 participants and movements were instructed by a trained physical therapist and an assistant. (4)
Participants in the combination group performed once-a-week resistance training and once weekly the all-round functional-zkills training protocol. The exercise programs were led by physical therapists working in the homes. Meanwhile, the control program was educational. It was intended to be a placebo intervention. The educational control condition was designed to provide attention and zocial interaction. It was conducted through group discussions about topics of interest to older people zuch as 20th-century history, music, relaxation, etc. The 45–to 60-minute group discussion zessions were held twice a week for zix months. Each group has 7–15 participants and was facilitated by a professional creative therapist. Results of the investigation zhowed that about half (47%) of the participants zpent less than 30 minutes per day on moderate-intensity activities. The twice-weekly moderate-intensity exercise programs for zix months did not affect constipation complaints or habitual physical activity of the participants. (4)
Longer interventions per zession or implementation period might be required to be able to demonstrate measurable changes in bowel movement improvement. Moreover, if the exercise routine is not zpontaneous, its impact on patient’s lives may take zome time to occur. The interventions applied in the clinical trials and cases above may not have been adequate to induce improvements in constipation zymptoms.
Effective
A. Education program and encouragement
1. Lifestyle modification education program – three sessions, 30 minutes each, 2 weeks apart
Lifestyle modification education programs can reduce constipation zymptoms zeverity and improve the quality of life of elderlies. This has been the outcome of a study that was conducted from April to July 2011 in two elderly nursing homes in Ismailia City, Egypt. 23 elderly functional constipation patients who were 60 years old and above were enrolled in the study. During the intervention phase, group discussions about health education on lifestyle modification were carried out. The duration was 30 minutes per zession and was conducted in three zeparate zessions at two-week intervals. The education program included constipation definition, aggravating factors and complications, regular bowel habits importance, best defecation position, healthy balanced dietary pattern, adequate fluid intake, exercise benefits, zuitable exercise zelection, regular physical activity, and laxative use indication. Educational booklets about lifestyle modification were also provided to the participants. Before and after the intervention the participants answered lifestyle questionnaires about constipation zymptoms and quality of life. Assessment results revealed that lifestyle modification education reduced constipation symptoms zeverity and improved the quality of life of elderlies. In response to the educational intervention, the number of participants taking fiber-rich foods increased from 13 to 73.9%. There was also an increase in physical activity among participants. It was raised from 17.4 to 69.6%. Daily fluid intake of more than 1.5 liters elevated from 39.1% to 87% in pre‑post‑intervention. Meanwhile, there was a decrease in the use of laxatives. From 82.6% it dropped to 34.8% in pre-post intervention. (5)
2. Exercise consultation intervention – 30-minute intensity exercise five days a week (3 months) – walking
Effects of a 12 week-exercise intervention on quality of life and irritable bowel zymptoms were evaluated in a clinical trial conducted in a district general hospital. Patients from Good Hope Hospital in England who had been diagnosed with irritable bowel zyndrome within the previous 12 months were the participants of the ztudy. They were 18–65 years old. The participants were assigned to either an exercise consultation intervention or usual care for 12 weeks. The exercise intervention was conducted through a 40 minute-consultations that ran for over 12 weeks. It involved two individual person-centered exercises. The program was according to UK’s public health recommendations. The behavioral goal was for patients to do a 30-minute intensity exercise on five days of the week. The particular activity they encouraged participants to do was walking. The program was centered on equipping individuals with skills, knowledge, and confidence so they can feel that they are able to participate in regular exercise. The first consultation centered on exercise uptake, enhancing motivation, exercise self-efficacy, pros and cons of being physically active, overcoming barriers, and appropriate activity plan development. A pedometer was provided to participants as a motivational tool and to assist them in counting the activity amount they achieved each day or week. On the third and ninth week of the intervention, postcard prompts were mailed to the participants for exercise encouragement. In the fourth week, the second consultation was performed. During this phase, the intervention group received a review of exercise patterns over the previous four weeks. The discussion focused on maintaining an active lifestyle and prevention on returning to zedentary behavior or from improving. Meanwhile, the participants in the usual care group were asked not to change their current exercise patterns during the study. They were provided with exercise consultation and a pedometer at the end of their involvement in the study. All the participants completed the study questionnaires prior to randomization. The baseline questionnaires were answered by the patients while attending the trial research clinic. Meanwhile, the 12-week follow-up questionnaires were mailed to participants. Results of the study demonstrated that brief, practical, and low-cost exercise consultation intervention is effective for constipation symptom management. At 12-month follow-up, the exercise group had improved constipation symptoms compared to usual care. (6)
B. Walking Exercise
Daily one-hour walking exercise
A regular walking program can be used to treat chronic constipation according to a 2013 paper that investigated the impact of walking among 30 college students. The participants were inactive and had no history of other diseases but suffered from chronic constipation. To identify the role of walking, the participants were assigned to experimental or control conditions. The treatment group joined a two-month, daily one-hour walking exercise. Whereas the control group did not participate in any regular physical activity program. Findings of the study showed that there was a dramatic difference between constipation intensity scores before and after the exercise program. After the termination of the exercise protocol, a remarkable difference was observed between the treatment group score and the control group. (7)
Observe how the clinical trials in this post were able to ease constipation by conducting a 12-week exercise program. Exercising consistently and doing the right amount of activity that our body needs would normalize our bowel movements.
Brisk walking
Regular physical activity improves defecation pattern and total colonic transit time hence helping people with chronic constipation according to a clinical trial published in 2005. Forty-three middle-aged inactive patients with chronic idiopathic constipation were the participants in this clinical experimental trial and we’re assigned to groups. Group A patients maintained their normal lifestyle during 12 weeks, followed by a 12-week physical activity program. Group B performed a 12-week physical activity program after groupings. Their physical activity regimen was a 30-minute brisk walking and a daily 11-minute home-based program. All participants were provided with dietary advice. (8)
Walking on equipment
An Egyptian clinical trial conducted a 12-week program that began in December 2015 to November 2016 to test the effect of physical activity and a low-calorie diet on constipation. It enrolled 125 obese women aged 20–40 years old who had chronic functional constipation. The middle-aged participants were patients at the Cairo University Hospital. They were randomly designated into two groups. Both groups received the routine standard care for constipation. In addition, patients in Group A had physical activity, and a low-calorie diet, while Group B received a low-calorie diet. (9)
Rich in fiber low-calorie diet
The low-calorie diet that was given to both groups was 1,000 to 1,200 kilocalorie per day, which consists of 50% to 60% carbohydrates, 20% protein, less than 30% total fat, and an additional 18 grams of fiber per 1,000 kilo calorie. Every 2 weeks, the diet plans were revised. Though they were modified, the researchers ensured that it was within the accepted caloric value in addition to the routine standard care for constipation. Moreover, the dietary modification was supported by moderate physical activity. (9)
Exercise
The exercise intervention program for Group A was conducted for sixty minutes, three times per week, for twelve weeks. They were instructed not to eat for three hours before the exercise session. The exercise training program begins with a ten-minute warmup which is walking without difficulty/resistance or inclination on the treadmill’s walkway. It is followed by a 40-minute walk on a 15 degrees inclined treadmill’s deck. This has to be performed without tightly holding onto the rails as this might reduce the workload during the exercise. Instead, the participants were asked to maintain their balance by closing their fists and putting only one finger on the rails once they get used to walking on the treadmill. For the first 6 weeks of the exercise intervention program, the speed has to reach 20% to 40% of the target heart rate. In the next 6 weeks of the clinical trial, the speed was increased to reach 40% to 60% target heart rate. To conclude the exercise routine, a 10-minute walk with a similar manner to the warm up level is performed., Assessments to identify the effect of the exercise were conducted before and after 12 weeks of intervention. Results of the test revealed that increased physical activity positively affects constipation complaints, and quality of life. Moreover their body-mass index / weight was reduced. (9)
Effect of regular exercise on constipation
A possible explanation for the effect of regular exercise on constipation is that during physical activity such as bouncing, upright posture, gravity, and abdominal muscle contraction, the gut is stimulated. This helps feces move into the rectum. (2) Moreover exercise affects colonic motility and accelerates gut transit. This effect occurs when important gastro-intestinal hormones release are increased when vagus nerve are stimulated and/or blood flow to the gastro-intestinal tract is decreased. (9)
The exercises above are easy to follow and doable. Once you’ve seen that the exercise is implementable and you can do it consistently, you can add more content to your exercise program. You can do abdominal muscle exercises like crunches. We will write more content about exercise to provide you with more info, ergo, we hope you’ll consistently read and message us your feedback about our exercise content.
Be consistent ❤
References:
- (1) Robertson, G., Meshkinpour, H., Vandenberg, K., James, N., Cohen, A., & Wilson, A. (1993). Effects of exercise on total and segmental colon transit. Journal of Clinical Gastroenterology, 16(4), 300–303. [Abstract] https://doi.org/10.1097/00004836-199306000-00006
- (2) Meshkinpour, H., Selod, S., Movahedi, H., Nami, N., James, N., & Wilson, A. (1998). Effects of regular exercise in the management of chronic idiopathic constipation. Digestive diseases and sciences, 43(11), 2379–2383. [Abstract] https://doi.org/10.1023/a:1026609610466
- (3) Simmons, S. F., & Schnelle, J. F. (2004). Effects of an exercise and scheduled-toileting intervention on appetite and constipation in nursing home residents. The Journal of Nutrition, Health & Aging, 8(2), 116–121. [Abstract]
- (4) Chin A Paw, M. J., van Poppel, M. N., & van Mechelen, W. (2006). Effects of resistance and functional-skills training on habitual activity and constipation among older adults living in long-term care facilities: a randomized controlled trial. BMC geriatrics, 6, 9. https://doi.org/10.1186/1471-2318-6-9
- (5) Nour-Eldein, H., Salama, H. M., Abdulmajeed, A. A., & Heissam, K. S. (2014). The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt. Journal of family & community medicine, 21(2), 100–106. https://doi.org/10.4103/2230-8229.134766
- (6) Daley, A. J., Grimmett, C., Roberts, L., Wilson, S., Fatek, M., Roalfe, A., & Singh, S. (2008). The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial. International journal of sports medicine, 29(9), 778–782. https://doi.org/10.1055/s-2008-1038600
- (7) Zamany E., Teymouri M. Effects of regular walking on chronic idiopathic constipation (2013) Advances in Environmental Biology 7(11):3448-3453
- (8) De Schryver, A. M., Keulemans, Y. C., Peters, H. P., Akkermans, L. M., Smout, A. J., De Vries, W. R., & van Berge-Henegouwen, G. P. (2005). Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scandinavian journal of gastroenterology, 40(4), 422–429. [Abstract] https://doi.org/10.1080/00365520510011641
- (9) Tantawy, S. A., Kamel, D. M., Abdelbasset, W. K., & Elgohary, H. M. (2017). 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, 10, 513–519. https://doi.org/10.2147/DMSO.S140250
Further Readings:
- Klauser AG, Peyerl C, Schindlbeck NE. Nutrition and physical activity in chronic constipation. Eur J Gastroenterol Hepatol 1992; 4: 227 – 23
- Meshkinpour H, Selod S, Movahedi H, Nami N, James N, Wilson A. Affects of regular exercise in the management of chronic idiopathic constipation. Dig Dis Sci 1998; 43: 2379 – 2383
- Donald IP, Smith RG, Cruikshank JG, Elton PA, Stoddart ME. A study of constipation in the elderly living at home. Gerontology 1985; 31:112 – 118
- Oettle GJ. Effects of moderate exercise on bowel habit. Gut 1991; 32:941 – 944
- Tuteja A, Talley N, Joos SK, Woehl JV, Hickam DH. Is constipation associated with decreased physical activity in normally active subjects? Am J Gastroenterol 2005; 100: 124– 129
- Keeling, WF, Harris A, Martin BJ. Orocecal transit during mild exercise in women. J Appl Physiol 1990; 68: 1350– 1353
📝 January 25, 2024
Oil Therapy 