PT on the Net Research

Irritable Bowel Syndrome


Question:

I have a client who suffers from irritable bowel syndrome. She states that whenever she tries walking as part of her weight loss program, she finds herself having to quickly get to the toilet! She is obese and is desperate to do some form of exercise, but this problem is holding her back. Any suggestions please?

Answer:

As sad as this problem is, it happens to be very popular. It is estimated that about one in five adult Americans have symptoms of irritable bowel syndrome (IBS). Interestingly, it is estimated that fewer than half seek help. It is rare for a client to talk about this problem. Also, twice as many women suffer than men.

The cause or causes are not well understood. However, some possible causes are: 

Note: Many different disorders have been linked to IBS (over 100). One disorder that has been linked in about 25 percent of adults is arthritis. Arthritis is also common in the obese population.

IBS is usually painful, but it is not serious. Most people who have it can lead active lifestyles if they change their diet, participate in regular exercise and replace lost nutrients. With this in mind, I have listed some suggestions for you.

  1. Consult with a nutritionist, as well as your client's physician. Many clients are closer to their trainers than their doctors. Find out if your client has explained this situation with her doctor.
  2. Recommend a high fiber diet, including plenty of fruits and vegetables. Brown rice and legumes are highly encouraged.
  3. Have your client avoid food that encourages the secretion of mucus by the membranes and prevent the uptake of nutrients. For example:
    • Animal fats
    • Butter
    • All carbonated beverages
    • Substances containing caffeine
    • Dairy products
    • Additives such as sorbitol & mannitol
    • Sugar free chewing gum
    • Wheat products
    • Alcohol (it can irritate the linings of the stomach and colon)
  4. Recommended wearing loose fitting clothes, especially around the waist.

Deep breathing exercises should also be practiced. First, assess if your client breathes correctly. Shallow or chest breathing reduces the oxygen that is available for proper bowel function. Use the guideline below as an assessment of your client's breathing ability. It is beyond the scope of this article to discuss different teaching techniques. However, use the information below to assess and help the teaching process.

  1. Lie the client down supine.
  2. Put one hand on the stomach and one on the chest.
  3. Have the client breath in deeply.
  4. If on inhalation the chest rises prior to abdomen, they fail!
  5. If on inhalation the abdomen moves inward and the chest rises first, they really failed!
  6. Proper breathing occurs when on inhalation, the lower abdomen slightly protrudes, followed by a lateral excursion of the ribs.
  7. Note: If your client is not breathing correctly, chances are the deep abdominal wall musculature is not working properly. The function and strength of this entire region will be critical to your client's every day function.

If proper abdominal exercise and diet is not working, the problem may be outside the realm of personal training.