Physical Activity
A common line of advice
Physical activity, such as exercise, is frequently advocated for treatment of chronic constipation. The trifecta of first line treatment is the combination of increased fiber intake, increased water intake, and more exercise. Of the three, the one that is uniformly accepted to alleviate chronic constipation in a subpopulation of patients is increased insoluble fiber intake.
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However, increased water intake and exercise are controversial at best. Currently, there is very little evidence to support the notion that exercise alleviates constipation.
Looking anywhere on the internet, one can find much "advice" regarding the efficacy of exercise in curing chronic constipation. The advice is backed up by arguments regarding how exercise increases heart and respiration, which stimulates the intestinal muscles. In addition, much of the advice advocates a clear schedule for exercising, proposing that avoidance of exercise within the first hour of eating is best. The advice is quite reasonable, but is there scientific evidence to back it up?
The theory behind exercise
The basic reasoning of exercise advocates for chronic constipation is that movement of the striated, or regular muscles also stimulate the intestinal tract to contract, causing stool to transit quicker. The truth is that the intestinal muscles are smooth muscle, activated autonomously without requiring input conscious control. Although some suggest that physical activity has an impact on how smooth muscle contracts, the evidence is not strong. To answer this question definitively, several studies have been carried out to test the hypothesis that physical activity is an effective form of constipation treatments.
Study shows no benefits
In a study by medical scientists at University of California Irvine (Meshkinpour et al), the effects of exercise on chronic constipation was studied for a very small group of sufferers who had idiopathic primary constipation. That is, they were afflicted with constipation of unknown origins. The study took this small group and put them on an exercise regimen. They were told to exercise one hour every day for five days a week, while sticking to a normal diet without high amounts of insoluble fiber. Many elected to do running, and covered on average 3 miles a day compared to 1.8 miles for normal people measured with a pedometer. The exercise regiment went on for six weeks. Afer this time, the scientists again assessed the group for their chronic constipation compared to the normal population.
Exercise is still healthy in general
There were certainly benefits. All of the patients in the study group reduced the amount of time it took to jog or run the 3 miles, pointing at a general improvement in cardiovascular fitness. However a careful study of the severity of their chronic constipation showed no improvement at all. This was based on three scores to assess constipation. The conclusion is that moderate exercise, as exemplified by the study, has little impact on constipation.
Sources:
Muller-Lissner et al, Myths and Misconceptions about Constipation, American Journal of Gastroenterology, 2005, 100:232-242