Exercise guide
Irritable bowel syndrome (IBS) is a common, long-term condition that causes tummy pain, bloating, diarrhoea or constipation, often coming and going. Being more active is part of the first advice from the National Institute for Health and Care Excellence (NICE) and the NHS. In trials it helped many people, but the studies are small and the evidence is weak.
Walking, cycling, jogging and yoga have all been tested, and none has been shown to beat the others. Diet changes, medicines and talking therapies have stronger evidence, and exercise works alongside them.
This guide covers what the trials found, how much to do, yoga, bloating and wind, urgency and toilets, constipation and runner's gut, with 3D demos of the moves and the signs that mean you should see a GP.
NICE asks GPs to check how active people with IBS are, to give brief advice to those who aren't very active, and to encourage time to relax. The NHS says "get plenty of exercise" and "try to find ways to relax", and the charity Guts UK says regular exercise should be part of a healthy lifestyle.
In a Cochrane review of 11 trials with 622 people, being more active improved IBS symptoms more than usual care, but the certainty is very low, and tummy pain and quality of life didn't clearly change. In the largest trial, 8% of people who became more active got worse over 12 weeks, against 23% of those who didn't.
Walking, jogging, cycling, swimming and yoga were all tested. Yoga did about as well as walking, and as well as a low-FODMAP diet (cutting down certain carbohydrates that ferment in the gut). Build towards the NHS's 150 minutes of moderate activity a week, the kind where you can talk but not sing, with strength exercises on 2 days.
In a small lab study, light pedalling cut the gas people's guts held on to from 45% to 24% and eased their bloating. A tummy that visibly swells after meals is often a reflex of the diaphragm, which breathing retraining with biofeedback reduced in two trials.
Choose routes and venues with toilets, carry a free "Can't Wait" card or a RADAR key for locked accessible toilets, and ask a GP about specialist help with pelvic floor exercises if you leak or can't hold on.
They carry more of the evidence for IBS than exercise, which works alongside them. Ask for an urgent GP appointment or call NHS 111 if you lose a lot of weight for no reason, bleed from your bottom or have bloody diarrhoea, find a lump in your tummy, or are short of breath with palpitations and pale skin.
IBS is a common condition of the digestive system that causes stomach cramps, bloating, diarrhoea and constipation. The NHS says the symptoms tend to come and go, can last days, weeks or months at a time, and that it's usually a lifelong problem. It has been linked with food moving through the gut too fast or too slowly, an oversensitive gut, gut infections, stress and family history. Specialists now call it a disorder of gut-brain interaction.
The main symptoms are tummy pain or cramps that are usually worse after eating and better after a poo, bloating, diarrhoea with sudden urges, and constipation with straining. Wind, mucus in your poo, tiredness, feeling sick, backache, bladder problems and pelvic pain are common too. Alcohol, caffeine, spicy or fatty food, stress and anxiety, and regular antibiotics can set symptoms off. About 1 in 3 people have IBS mainly with constipation (IBS-C), about 1 in 3 mainly with diarrhoea (IBS-D), and the rest a mix of both.
There's no single test. A GP diagnoses IBS from the pattern of symptoms, after a few tests to rule out other conditions: blood tests for coeliac disease and inflammation, and a poo test for infection and inflammatory bowel disease. NICE suggests thinking about IBS when tummy pain or discomfort, bloating or a change in bowel habit has lasted 6 months or more.
By today's diagnostic criteria (called Rome IV), about 4.4% to 4.8% of adults in the UK, US and Canada have IBS; older criteria gave about 11%. It's more common in women, twice as many women as men are diagnosed, and it's less common after 50. Three in four people in the largest exercise trial were women, but nothing suggests the advice should differ between women and men.
Exercise can speed up the gut, helps clear trapped gas in people with bloating, and might change the mix of gut bacteria. But in the largest trial, symptoms improved without any change in how fast food moved through the gut or in the type of poo. The trial's authors think several things are at work, physical and psychological, including the link between the gut and the brain and probably some placebo effect.
A 2022 Cochrane review found 11 trials with 622 people: yoga (5 trials), supervised treadmill walking or jogging (2), support to be more active (3), and Qigong, a Chinese practice of breathing and slow movement (1). Compared with usual care, being more active improved IBS symptoms (5 trials, 185 people), and the difference was large, but the certainty was very low: the trials were small, at risk of bias and inconsistent. Quality of life and tummy pain didn't clearly change, and harms were too poorly reported to judge.
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In Sweden, 102 people with IBS were randomly assigned either to be helped by a physiotherapist to be more active, with phone calls once or twice a month for 12 weeks, or to carry on as usual; 75 finished. Symptoms improved by a median of 51 points on a 500-point scale with activity, against 5 points without it. 43% against 26% improved by more than 50 points, a difference that could be chance, and 8% against 23% got worse.
39 of the 76 people invited back were followed up about 5 years later. Their symptoms were still better than at the start (218 against 276 points), they were doing about 5 hours of activity a week instead of 3, mostly walking, aerobics and cycling, and 54% had improved by a meaningful amount. There was no comparison group, and only half took part.
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In a UK trial of 56 people, two exercise consultations, a pedometer and reminders by post over 12 weeks improved constipation, but not overall symptoms or quality of life. Only 18% of the people invited agreed to take part.
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A 2026 review of 10 trials (437 people) found exercise improved IBS symptom scores, but not quality of life or anxiety, with low certainty and very varied results. Another 2026 review compared types of exercise across 16 studies and ranked moderate aerobic exercise, Pilates and running highly, but with low confidence in the rankings.
A 2016 review of 6 trials (273 people) found yoga helped bowel symptoms, IBS severity and anxiety, but made no recommendation because of flaws in the studies. In 2025, a review of 11 trials (535 people) found no clear difference from control groups in symptoms, anxiety, depression or quality of life, and said yoga can't yet be recommended as a treatment; another 2025 review was more positive. Pooled, Cochrane's 5 yoga trials gave a very uncertain result.
Yoga and walking did about as well as each other in 2 trials (124 people, very low certainty). In 59 people over 12 weeks, yoga did about as well as a low-FODMAP diet, with both improving symptoms.
In a trial of 79 adults (92% women), 8 weekly online yoga classes of about an hour, with daily practice at home, led to a meaningful improvement in symptoms in 37% of people, against 20% with advice alone, a difference that could be chance. Quality of life and tiredness improved more with yoga, and no harms were reported.
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In a 4-week pilot study of 14 adults, 20 minutes of slow deep breathing 5 times a week didn't change IBS symptoms. It's a good way to relax, but it hasn't been shown to treat IBS by itself.
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These have more evidence than exercise. Soluble fibre such as ispaghula, peppermint oil, low-dose amitriptyline and psychological therapies such as IBS-focused cognitive behavioural therapy (CBT) and gut-directed hypnotherapy reduced symptoms in trials, and NICE recommends several of them. Antispasmodic medicines and a low-FODMAP diet can help too, though the evidence for them is of very low quality. A trial of 463 people in UK general practice found low-dose amitriptyline, adjusted by each person, effective and well tolerated.
Aerobic programmes were 20 to 60 minutes of walking, jogging, cycling or swimming, 3 to 6 times a week, at a moderate effort, for 6 to 24 weeks. Yoga programmes were classes of 60 to 90 minutes, once to 3 times a week, usually with practice at home, for 6 to 12 weeks.
Start with 10 to 20 minutes on most days at an easy to moderate pace, near a toilet if urgency is a problem, and add 5 minutes every week or two while your symptoms stay steady. Build towards 150 minutes of moderate activity a week, plus strength exercises on at least 2 days. Give a new routine about 12 weeks, the length of most trials, before you judge it.
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Many people find a set time that suits their bowel pattern easier, such as after the morning toilet visit. A short walk after meals may help with wind (our suggestion, from the gas studies below).
Make the session shorter or gentler rather than stopping, and look at what you eat and drink before it. The NHS suggests no more than 3 cups of tea, coffee or other caffeinated drinks a day, not drinking lots of alcohol or fizzy drinks, and avoiding products with the sweetener sorbitol. Very long or hard sessions, especially in heat, can upset anyone's gut. Pre-workout drinks and energy gels often contain caffeine, sweeteners or concentrated sugar, so check the label (our tip).
NICE asks people with IBS to make time to relax, and stress and anxiety are common triggers. Slow breathing, yoga or a walk can help you unwind. If stress or low mood is a big part of your IBS, talking therapies designed for IBS have good evidence, and in England you can refer yourself to NHS Talking Therapies.
Build up to 20 to 60 minutes, 3 to 5 times a week, at a pace where you can talk but not sing (the trials' range). Walking outdoors and swimming count too, and indoor options keep a toilet close.
3D demoTreadmill walkingBeginner · Cardio machine
3D demoStationary cyclingBeginner · Cardio machine
3D demoRecumbent exercise bikeBeginner · Cardio machine
3D demoElliptical trainerBeginner · Cardio machine
3D demoTreadmill joggingIntermediate · Cardio machine
3D demoStanding marchBeginner · No equipment
3D demoStep jack (low-impact jumping jack)Beginner · No equipment2 days a week, 2 to 3 sets of 8 to 15 of each (our editorial starting point). Breathe out as you push or lift, and don't strain or hold your breath.
The trials used whole classes rather than single poses: Hatha yoga for 75 minutes twice a week for 12 weeks, with daily practice at home; Iyengar yoga for about 60 minutes twice a week for 8 weeks, with seated poses, inversions, backbends, twists and restful poses lying down; or weekly online classes of about an hour with daily home videos. A beginners' class, or our gentle yoga routine twice a week, is closer to that than a list of poses.
Because the trials tested whole classes, and their results are mixed, no single pose has been shown to help IBS. Twists are a comfortable way to move your spine, but claims that a pose massages or stimulates your gut haven't been tested.
Lying face down, as in the cobra, sphinx, bow or locust, and deep forward folds with your knees together can feel uncomfortable when you're bloated. Choose standing poses, poses on your back, or child's pose with your knees wide so your tummy has room (our suggestion).
Hold standing poses for 30 to 60 seconds and restful poses on your back for 2 to 5 minutes (our editorial starting point). Use a wall for balance in the tree pose, and take your knees wide in child's pose if you're bloated.
3D demoCat-cowBeginner · No equipment
3D demoMountain pose (Tadasana)Beginner · No equipment
3D demoWarrior II (Virabhadrasana II)Intermediate · No equipment
3D demoTree pose (Vrksasana)Beginner · No equipment
3D demoChild's Pose (Balasana)Beginner · No equipment
3D demoSupine spinal twist (Supta Matsyendrasana)Beginner · No equipment
3D demoReclined figure four (eye of the needle, Sucirandhrasana)Beginner · No equipment
3D demoReclining bound angle pose (Supta Baddha Konasana)Beginner · Firm cushion
3D demoLegs up the wall (Viparita Karani)Beginner · A wall
3D demoCorpse pose (Savasana)Beginner · No equipmentIn 8 people with bloating (7 with IBS), light pedalling while lying back, 5 minutes on and 3 off, cut the gas their guts held on to from 45% to 24% and eased their symptoms. In 8 healthy people, it did the same and reduced swelling of the tummy. These were short lab studies with gas fed into the gut, so they explain why a walk after meals may help rather than prove it does.
When the tummy visibly swells after meals, the diaphragm often pushes down while the front of the tummy relaxes. In two placebo-controlled trials from one research group, people learned to control their diaphragm and tummy wall with biofeedback, which shows them their muscle activity or tummy movement as they practise, over 3 sessions. The swelling fell by 56% (against 13% with placebo; 48 people) and by 66% (42 people). The American Gastroenterological Association lists diaphragmatic breathing as a treatment for it. Practising at home without the equipment hasn't been tested.
The NHS suggests eating oats regularly and up to 1 tablespoon of linseeds a day, avoiding hard-to-digest foods such as cabbage, broccoli, cauliflower, sprouts, beans and onions and products with the sweetener sorbitol, and asking a pharmacist about Buscopan or peppermint oil. A GP can refer you to a dietitian for a low-FODMAP diet. The NHS suggests trying probiotics for a month, while the American gastroenterology experts advise against them for bloating.
If you're bloated and find it hard to empty your bowels, ask a GP: the American experts suggest tests of how your bowel empties, and biofeedback therapy if the pelvic floor muscles aren't working well together.
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Slow breathing for at least 5 minutes, with no need to hold your breath (the NHS's exercise for stress); lateral breathing fills your lower ribs while your tummy stays soft. Skip face-down crocodile breathing when you're bloated.
3D demoSlow breathing (6 breaths a minute)Beginner · No equipment
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoAlternate nostril breathing (Nadi Shodhana)Beginner · No equipment
3D demoBreath reachBeginner · No equipment
3D demoCrocodile breathing (prone diaphragmatic breathing)Beginner · No equipmentSudden urges are part of IBS with diarrhoea, and NICE notes that about 1 in 5 people with bowel leaking only mention it if they're asked. IBS is one of the causes of bowel incontinence, and help is available, so try not to be embarrassed: doctors are used to talking about it.
Plan an easy route to a toilet when you're out, wear clothes that are easy to get off in a rush, and get a RADAR key for locked accessible toilets. Guts UK and the Bladder & Bowel Community offer free "Can't Wait" cards; they don't guarantee access, but many cafés, shops and other businesses accept them.
Choose routes and venues with toilets, such as park loops, gyms and pools. Go before you start, tell an instructor privately so you can slip out, carry wipes and spare underwear, and start with short loops close to home.
If you leak or can't hold on, a GP can refer you to a specialist service, which may recommend exercises to strengthen your pelvic floor and the muscles around your bottom (sometimes with biofeedback) and bowel retraining. Our pelvic floor guide covers the technique.
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If you keep getting diarrhoea, drink plenty of water to avoid dehydration. Loperamide is NICE's first choice of medicine to slow diarrhoea in IBS, with the dose adjusted to aim for soft, well-formed poo; ask a pharmacist or GP how to use it.
Squeezes: 8 slow holds of up to 10 seconds and 8 quick squeezes, 3 times a day, the dose UK pelvic health physiotherapists suggest. If you strain or struggle to empty, learn to relax the muscles first.
The NHS says a daily walk or run can help you poo more regularly. In IBS, one trial found exercise improved constipation, and in 9 trials of people with constipation (680 people), exercise helped, though those trials were small and at high risk of bias.
With IBS, soluble fibre such as oats, pulses, carrots, peeled potatoes, linseeds or ispaghula usually suits better than other kinds of fibre. Drink plenty of water, rest your feet on a low stool on the toilet so your knees are above your hips, and don't put off going when you feel the urge.
Straining, or a feeling you haven't finished, can mean the pelvic floor muscles aren't relaxing properly, so don't strain. A GP can arrange tests and biofeedback therapy if needed, and our pelvic floor guide covers learning to relax these muscles.
Studies suggest 30% to 50% of endurance athletes get gut symptoms during exercise, and up to 90% of distance runners in some studies; symptoms are more common in runners than in cyclists. In 96 recreational marathon runners, 27% had moderate symptoms during the race. Severe symptoms affected about 4% of people in marathons and cycling races, but 32% in Ironman triathlons.
During long or hard exercise, blood is diverted from the gut to the muscles, falling by 80% or more, and running jostles the gut. Fibre, fat, protein, fructose, very concentrated drinks and dehydration make symptoms more likely. Gut problems become much more common in sessions of about 2 hours or more at a moderate pace or harder, especially in heat.
The advice comes from limited research and athletes' experience:
In 11 runners with gut symptoms, 6 days of low-FODMAP eating reduced daily wind, urgency and loose poo compared with high-FODMAP eating, though not symptoms during runs. Practising taking in carbohydrate during training reduced gut discomfort in some small studies. To try a low-FODMAP diet for longer, ask a GP to refer you to a dietitian.
Runner's gut happens to people without IBS too, so symptoms on a run don't mean your IBS is worse. Start with shorter runs on loops with toilets, keep caffeine and sweeteners low beforehand, leave time after eating, and build your distance gradually.
Blood in your poo after a hard endurance event can come from reduced blood flow to the gut and can be serious. Ask for an urgent GP appointment or call NHS 111 for bleeding from your bottom, bloody diarrhoea, or black or dark red poo.
Gentle yoga for beginners is closest to the trial classes and has no face-down poses. In the other routines, skip face-down poses on bloated days; the breath holds in box and 4-7-8 breathing are optional.
A 25-minute gentle yoga class for complete beginners and over-50s: slow breathing, a warm-up, supported standing poses, floor poses and a closing rest.
25 minBeginner14 movesNo equipmentA 20-minute beginner yoga sequence: mountain, chair, warrior II, triangle, tree, down dog, cobra and child's pose.
20 minBeginner11 movesA stepA 45-minute session for weight loss and health: a 20-minute brisk walk, which does more for the scales, then a standing yoga flow for strength and balance.
45 minBeginner12 movesCardio machineA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.
25 minBeginner9 movesA bench or box, A stepA 25-minute walk with short faster bouts: notice your heart and breathing speed up, then settle. A gentle way to get used to the feelings of effort.
25 minBeginner5 movesCardio machine, A wallA 10-minute routine for straight after a meal: an easy walk, a few simple standing moves from blood sugar trials, then a short walk to finish.
10 minBeginner6 movesCardio machine, A bench or boxA gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallA 5-minute daily pelvic floor workout for women and men: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentAn 8-minute routine for a tight pelvic floor: slow breathing and comfortable positions to help the muscles let go, with no strengthening squeezes.
8 minBeginner5 movesFirm cushionA slow, 10-minute floor routine to unwind before sleep: child's pose, twists, happy baby and slow breathing.
10 minBeginner7 movesFirm cushion, A wallFour weeks of short home sessions with no gym needed.
The NHS says these could be signs of something more serious:
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IBS and anxiety or low mood can feed into each other, and our anxiety and depression guides can help. If you are thinking about suicide or can't keep yourself safe, call 999 or go to A&E. For urgent help, call Samaritans free on 116 123, any time, or in England call 111 and select the mental health option. In the US, call or text 988.
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In the largest trial, people helped to be more active were less likely to get worse (8% against 23%), and NICE and the NHS recommend activity. What is true is that very long or hard sessions, especially running in the heat, can upset anyone's gut.
The trials tested whole yoga classes, with mixed results, and no trial has tested a single pose on digestion. Twists are fine for comfort.
Yoga did about as well as walking in 2 trials and as a low-FODMAP diet in 1. Choose the activity you'll keep doing.
No guideline says so, and supervised walking or jogging was part of the trials. Gut symptoms on runs are common in everyone and are managed by building up gradually; some people prefer cycling or swimming when their symptoms are bad.
Visible swelling after meals is usually a reflex of the diaphragm and tummy wall rather than weak muscles. The treatment that worked in trials retrained the diaphragm with biofeedback; no trial has tested sit-ups for bloating.
Slow breathing helps you relax, but in a small pilot study it didn't change IBS symptoms. Talking therapies designed for IBS, such as CBT and gut-directed hypnotherapy, are a different treatment with good evidence.
For many people, yes, though the evidence is weak. In a review of 11 trials, being more active improved IBS symptoms compared with usual care, but the certainty was very low, and in the largest trial far fewer active people got worse over 12 weeks. NICE and the NHS include physical activity in their first advice for IBS.
There's no single best one. Walking, jogging, cycling, swimming and yoga were all tested, and yoga and walking did about as well as each other. Choose something you enjoy, and build towards 150 minutes a week plus strength work on 2 days.
Gentle and moderate exercise rarely does: in the largest trial, people who became more active were less likely to get worse. Long, hard sessions, especially running in the heat, can upset anyone's gut. If a session seems to set you off, make it shorter or gentler and look at what you eat and drink before it.
It helps some people, but it isn't proven. Small trials found benefits, a 2025 review of 11 trials found no clear difference from control groups, and yoga did about as well as walking and as a low-FODMAP diet. If you enjoy it, a beginners' class twice a week is closer to what the trials used than a list of poses.
Gentle movement helps trapped wind move on: in a small study, light pedalling reduced the gas people held on to and eased their bloating, so a walk after meals is worth trying. If your tummy visibly swells after meals, retraining the diaphragm reduced it in two trials. When you're bloated, poses on your back or standing are usually more comfortable than lying face down.
Yes. Walking was the most common activity among people who kept their improvement 5 years after the Swedish trial, and the NHS says a daily walk or run can help you poo more regularly. It's easy to plan around toilets and to build up gradually.
Choose routes and venues with toilets, go before you start, and carry a free Can't Wait card or a RADAR key for locked accessible toilets. Home workouts or a gym treadmill keep a toilet close. If you leak or can't hold on, ask a GP about specialist help, where pelvic floor exercises and bowel retraining can help.
Runner's gut is common in everyone, not just people with IBS: 30% to 50% of endurance athletes get gut symptoms. Blood flow to the gut drops during hard exercise, running jostles the gut, and fibre, fat, very concentrated drinks, dehydration and anti-inflammatory painkillers make it worse. Build up gradually, practise what you eat and drink, and get any blood in your poo checked.
They're a good way to relax, and NICE asks people with IBS to make time to relax, but a small trial of slow breathing on its own didn't change IBS symptoms. Retraining the diaphragm helps a tummy that visibly swells after meals. Talking therapies designed for IBS have much stronger evidence.
It may: in one trial, an exercise programme improved constipation, and in people with constipation generally, exercise helped in small, mixed-quality trials. Add soluble fibre such as oats or linseeds, drink plenty, don't strain, and rest your feet on a low stool on the toilet.
Build up towards at least 150 minutes of moderate activity a week, the kind where you can talk but not sing, plus strength exercises on 2 days. Most trials used 20 to 60 minutes, 3 to 6 times a week, so give a new routine about 12 weeks before you judge it.
See a GP if you've had symptoms for more than 4 weeks. Get an urgent appointment or call 111 if you've lost a lot of weight for no reason, are bleeding from your bottom or have bloody diarrhoea, find a lump in your tummy, or are short of breath with palpitations and pale skin. New bowel changes after 40, diarrhoea that wakes you at night or a fever also need checking, even if you've been diagnosed with IBS.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
