Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials

Associations between physical activity and constipation in adult Americans: Results from the National Health and Nutrition Examination Survey

“…While keeping in mind the substantial limitations of cross‐sectional, observational research (particularly when data is based on self‐report), these results provide some modest evidence that, on the population level, physical inactivity does not independently correlate with passing fewer than 3 stools per week or hard/lumpy stools. Even so, evidence from clinical trials does support the use of structured exercise—particularly aerobic exercise—as a means to modestly reduce constipation symptoms in certain populations, especially middle‐aged and older adults . Ultimately, the findings of this investigation highlight the need for additional and better‐designed prospective observational and intervention studies on how different modalities, intensities, and durations of physical activity impact the various forms of constipation.…”

“…Notably, these results do not mean that physical activity is entirely uninfluential with respect to bowel habits; indeed, results from clinical trials suggest that physical activity can have modest beneficial effects on constipation symptoms, particularly in older populations . Mechanistically speaking, exercise has been shown in some studies to stimulate colonic motility and accelerate gastrointestinal transit, which could translate, in theory, to a lower risk of constipation.…”

“…For example, the links between bowel habits and physical activity have long been an area of active research, as work from nearly a half‐century ago found that, in comparison with resting, engaging in light physical activity was associated with propulsive mass movements in the colon, suggesting that exercise could facilitate defecation. In addition, results from more recent clinical trials suggest that increasing physical activity reduces symptoms of constipation, though the evidence from these interventions has a high risk of bias . In the American Gastroenterological Association's 2013 technical review on constipation, it is stated that physical inactivity is a risk factor for constipation and that mild exercise increases intestinal gas clearance .…”

“…Although current literature supports the notion that physical activity may help in the prevention and management of constipation, some important questions remain to be addressed. Most of the clinical trials that have examined the effects of exercise on constipation were carried out in homogenous or highly selective populations, which, to a degree, limits what can be said about the relationships between physical activity and constipation in the general population. Some population‐representative observational studies of Americans have considered the links between constipation and physical activity, but they have notable limitations.…”

Constipation in chronic kidney disease: it is time to reconsider

“…In a recent meta-analysis, Gao et al suggested that exercise, such as walking, may be a feasible and effective strategy to ameliorate constipation-related symptoms and quality of life in the non-CKD population [94]. To the best of our knowledge, it currently remains unknown whether exercise interventions have a similar effect in CKD/ESKD patients.…”