INNOVATIVE APPROACHES IN IBS MANAGEMENT: THE ROLE OF PHYSICAL ACTIVITY AND WEARABLE TECHNOLOGIES

Keywords: IBS, Physical Activity, Exercise-Induced Stress, Microbiota, Wearable Technology, HRV

Abstract

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by disturbances in intestinal motility, alterations in gut microbiota, visceral hypersensitivity, and dysregulation of the gut-brain axis. In recent years, interest has increased in the potential role of physical activity as a supportive, non-pharmacological intervention for symptom management, particularly in individuals who engage in recreational exercise.

This review aims to summarize current evidence on the association between physical activity and IBS symptoms, with a focus on physiological mechanisms, stress-related pathways, and the integration of wearable health technologies.

Relevant publications, including clinical trials, systematic reviews, and meta-analyses published between 2016 and 2025, were identified through PubMed, Scopus, and Google Scholar. Studies examining gastrointestinal physiology, neuroendocrine responses to exercise, and digital monitoring tools were included.

Findings suggest that regular exercise promotes intestinal peristalsis, supports microbial diversity, and reduces low-grade inflammation through immune modulation. Physical activity also contributes to lowering cortisol levels and balancing neurotransmitter activity within the gut–brain axis. Moderate-intensity activities, such as walking or cycling, appear particularly beneficial in alleviating gastrointestinal and psychological symptoms. Furthermore, wearable devices-including fitness trackers, smartwatches, and HRV monitors-offer opportunities to personalize exercise regimens by capturing real-time physiological data and correlating it with symptom fluctuations.

In conclusion, moderate and consistent physical activity shows promise as an adjunctive therapeutic approach in IBS management. The incorporation of wearable technologies facilitates individualized treatment strategies and underscores the need for continued interdisciplinary research in this rapidly evolving field.

References

Oka, P., Parr, H., Barberio, B., Black, C. J., Savarino, E. V., & Ford, A. C. (2020). Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. The Lancet. Gastroenterology & Hepatology, 5(10), 908–917. https://doi.org/10.1016/S2468-1253(20)30217-X

Kamiya, T., & Shikano, M. (2024). Definition of irritable bowel syndrome. In Irritable Bowel Syndrome (pp. 3–11). Springer Nature Singapore.

Mearin, F., Lacy, B. E., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2016). Bowel disorders. Gastroenterology. https://doi.org/10.1053/j.gastro.2016.02.031

Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: trends, predictions and risk factors. Nature Reviews. Gastroenterology & Hepatology, 17(8), 473–486. https://doi.org/10.1038/s41575-020-0286-8

Oświęcimska, J., Szymlak, A., Roczniak, W., Girczys-Połedniok, K., & Kwiecień, J. (2017). New insights into the pathogenesis and treatment of irritable bowel syndrome. Advances in Medical Sciences, 62(1), 17–30. https://doi.org/10.1016/j.advms.2016.11.001

World Health Organization. WHO guidelines on physical activity and sedentary behaviour. (2020).

Costantino, A., Pessarelli, T., Vecchiato, M., Vecchi, M., Basilisco, G., & Ermolao, A. (2022). A practical guide to the proper prescription of physical activity in patients with irritable bowel syndrome. Digestive and Liver Disease: Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 54(11), 1600–1604. https://doi.org/10.1016/j.dld.2022.08.034

Motiani, K. K., Collado, M. C., Eskelinen, J.-J., Virtanen, K. A., Löyttyniemi, E., Salminen, S., Nuutila, P., Kalliokoski, K. K., & Hannukainen, J. C. (2020). Exercise training modulates gut Microbiota profile and improves endotoxemia. Medicine and Science in Sports and Exercise, 52(1), 94–104. https://doi.org/10.1249/mss.0000000000002112

Li, C., Li, J., Zhou, Q., Wang, C., Hu, J., & Liu, C. (2024). Effects of physical exercise on the Microbiota in irritable bowel syndrome. Nutrients, 16(16), 2657. https://doi.org/10.3390/nu16162657

Wang, Y., Bai, S., Yang, T., Guo, J., Zhu, X., & Dong, Y. (2025). Impact of exercise-induced alterations on gut microbiota diversity and composition: comparing effects of different training modalities. Cell Regeneration (London, England), 14(1), 28. https://doi.org/10.1186/s13619-025-00244-y

Moser, G., Fournier, C., & Peter, J. (2018). Intestinal microbiome-gut-brain axis and irritable bowel syndrome. Wiener Medizinische Wochenschrift (1946), 168(3–4), 62–66. https://doi.org/10.1007/s10354-017-0592-0

Kennedy, P. J., Cryan, J. F., Dinan, T. G., & Clarke, G. (2017). Kynurenine pathway metabolism and the microbiota-gut-brain axis. Neuropharmacology, 112(Pt B), 399–412. https://doi.org/10.1016/j.neuropharm.2016.07.002

Molina-Torres, G., Rodriguez-Arrastia, M., Roman, P., Sanchez-Labraca, N., & Cardona, D. (2019). Stress and the gut microbiota-brain axis. Behavioural Pharmacology, 30(2 and 3-Spec), 187–200. https://doi.org/10.1097/FBP.0000000000000478

Wiley, N. C., Dinan, T. G., Ross, R. P., Stanton, C., Clarke, G., & Cryan, J. F. (2017). The microbiota-gut-brain axis as a key regulator of neural function and the stress response: Implications for human and animal health. Journal of Animal Science, 95(7), 3225–3246. https://doi.org/10.2527/jas.2016.1256

Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., & Maher, C. (2023). Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine, 57(18), 1203–1209. https://doi.org/10.1136/bjsports-2022-106195

Chao, W. C., Huang, J. C., Young, S. L., Wu, C. L., Shih, J. C., Liao, L. D., & Cheng, B. (2024). Interplay of yoga, physical activity, and probiotics in irritable bowel syndrome management: A double-blind randomized study. Complementary therapies in clinical practice, 57, 101892. https://doi.org/10.1016/j.ctcp.2024.101892

De Nys, L., Anderson, K., Ofosu, E. F., Ryde, G. C., Connelly, J., & Whittaker, A. C. (2022). The effects of physical activity on cortisol and sleep: A systematic review and meta-analysis. Psychoneuroendocrinology, 143, 105843. https://doi.org/10.1016/j.psyneuen.2022.105843

Wood, C. J., Clow, A., Hucklebridge, F., Law, R., & Smyth, N. (2018). Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress. Anxiety, Stress, and Coping, 31(2), 135–145. https://doi.org/10.1080/10615806.2017.1390083

Xue, P., Du, X., & Kong, J. (2025). Age-dependent mechanisms of exercise in the treatment of depression: a comprehensive review of physiological and psychological pathways. Frontiers in Psychology, 16, 1562434. https://doi.org/10.3389/fpsyg.2025.1562434

Basso, J. C., & Suzuki, W. A. (2017). The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A review. Brain Plasticity, 2(2), 127–152. https://doi.org/10.3233/BPL-160040

Fani, M., Mostamand, J., Fani, M., Chitsaz, N., & Feizi, A. (2019). The effect of aerobic exercises among women with mild and moderate irritable bowel syndrome: A pilot study. Journal of Bodywork and Movement Therapies, 23(1), 161–165. https://doi.org/10.1016/j.jbmt.2018.02.003

Zhou, C., Zhao, E., Li, Y., Jia, Y., & Li, F. (2019). Exercise therapy of patients with irritable bowel syndrome: A systematic review of randomized controlled trials. Neurogastroenterology and motility, 31(2), e13461. https://doi.org/10.1111/nmo.13461

Papale, A. J., Flattau, R., Vithlani, N., Mahajan, D., & Nadella, S. (2024). A Review of Pharmacologic and Non-Pharmacologic Therapies in the Management of Irritable Bowel Syndrome: Current Recommendations and Evidence. Journal of Clinical Medicine, 13(22), 6948. https://doi.org/10.3390/jcm13226948

Radziszewska, M., Smarkusz-Zarzecka, J., & Ostrowska, L. (2023). Nutrition, Physical Activity and Supplementation in Irritable Bowel Syndrome. Nutrients, 15(16), 3662. https://doi.org/10.3390/nu15163662

Sadeghian, M., Sadeghi, O., Hassanzadeh Keshteli, A., Daghaghzadeh, H., Esmaillzadeh, A., & Adibi, P. (2018). Physical activity in relation to irritable bowel syndrome among Iranian adults. PLOS ONE, 13(10), Artykuł e0205806. https://doi.org/10.1371/journal.pone.0205806

Shahabi, L., Naliboff, B. D., & Shapiro, D. (2016). Self-regulation evaluation of therapeutic yoga and walking for patients with irritable bowel syndrome: a pilot study. Psychology, health & medicine, 21(2), 176–188. https://doi.org/10.1080/13548506.2015.1051557

Johannesson, E., Jakobsson Ung, E., Sadik, R., & Ringström, G. (2018). Experiences of the effects of physical activity in persons with irritable bowel syndrome (IBS): a qualitative content analysis. Scandinavian Journal of Gastroenterology, 53(10–11), 1194–1200. https://doi.org/10.1080/00365521.2018.1519596

Morrow, T. (2023). Physical activity for treatment of irritable bowel syndrome: Summary of a Cochrane Review. Explore (New York, N.Y.), 19(5), 774–775. https://doi.org/10.1016/j.explore.2023.06.011

Goldenberg, J. Z., Brignall, M., Hamilton, M., Beardsley, J., & Lichtenstein, B. (2017). Biofeedback for treatment of irritable bowel syndrome. The Cochrane Library. https://doi.org/10.1002/14651858.cd012530

Minjoz, S., Jeanne, R., Vercueil, L., Sabourdy, C., Sinniger, V., Bonaz, B., Hot, P., & Pellissier, S. (2025). Heart rate variability biofeedback to manage the mental health of adults with irritable bowel syndrome: A pilot study. Stress and Health: Journal of the International Society for the Investigation of Stress, 41(1), e70015. https://doi.org/10.1002/smi.70015

Pereira, A. G., Fu, L., Xu, W., Gharibans, A. A., & O’Grady, G. (2025). The effects of heart rate variability biofeedback on functional gastrointestinal disorders: a scoping review. Frontiers in Physiology, 16, 1511391. https://doi.org/10.3389/fphys.2025.1511391

Sadowski, A., Dunlap, C., Lacombe, A., & Hanes, D. (2020). Alterations in heart rate variability associated with irritable bowel syndrome or inflammatory bowel disease: A systematic review and meta-analysis. Clinical and Translational Gastroenterology, 12(1), e00275. https://doi.org/10.14309/ctg.0000000000000275

Chong, K. P., & Woo, B. K. (2021). Emerging wearable technology applications in gastroenterology: A review of the literature. World Journal of Gastroenterology: WJG, 27(12), 1149–1160. https://doi.org/10.3748/wjg.v27.i12.1149

Jerath, R., Syam, M., & Ahmed, S. (2023). The future of stress management: Integration of smartwatches and HRV technology. Sensors (Basel, Switzerland), 23(17). https://doi.org/10.3390/s23177314

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Published
2025-09-22
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How to Cite
Gabriela Szpila, Angelika Lewandowska, Natalia Nafalska, Małgorzata Stopyra, Krzysztof Feret, Michalina Chodór, Maciej Kokoszka, Agata Andrzejczyk, Joanna Gadzinowska, & Aleksandra Tomaszewska. (2025). INNOVATIVE APPROACHES IN IBS MANAGEMENT: THE ROLE OF PHYSICAL ACTIVITY AND WEARABLE TECHNOLOGIES. International Journal of Innovative Technologies in Social Science, 3(3(47). https://doi.org/10.31435/ijitss.3(47).2025.3988

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