Introduction ! Estimates suggest that irritable bowel syndrome (IBS) affects between 10 – 30% of the population [9, 30]. IBS is likely to cause a significant reduc- tion in quality of life (QoL) [8,10]. In recent years there has been increased interest in evaluating QoL interventions and reports suggest the major- ity of IBS patients use some form of self-treat- ment [30]. Studies involving healthy adults [26] have indicated that exercise can improve feelings and symptoms of fatigue, bloating and constipa- tion. Thus, it seems intuitively appealing to pro- mote participation in regular exercise in the management of IBS. Whilst IBS management pro- grammes often suggest that exercise might be a worthwhile health promoting activity, we found no randomised controlled trials (RCT) that have evaluated the effects of an exercise intervention in patients experiencing IBS. Moreover, observa- tional and non-randomised studies predomi- nantly involving healthy participants have pro- vided contradictory evidence of an association between IBS-related symptoms and exercise par- ticipation [2, 6,10,15, 20, 28]. While the underlying mechanisms for the poten- tial benefits of exercise on IBS symptoms are not fully understood, it has been suggested that de- creased gastrointestinal blood flow, neuroimmu- no-endocrine alternations, increased gastrointes- tinal motility and mechanical bouncing during exercise may be responsible [24]. The stress re- ducing effect of exercise has also been offered as a possible explanation [17] and studies [3,27] have reported reductions in feelings of stress and well-being after exercise in both healthy adults and clinical populations. Given the nature of IBS and associated symp- toms, achieving participation in regular exercise may be difficult for IBS patients. Therefore, we examined the feasibility of a brief exercise inter- vention that was intentionally pragmatic using a RCT methodology. This study also aimed to eval- uate the effects of exercise on IBS-specific QoL, symptoms associated with IBS and participation in exercise, in previously sedentary IBS patients. Abstract ! While it seems intuitively appealing to promote participation in regular exercise in the manage- ment of irritable bowel syndrome, limited ran- domised controlled trial evidence exists to sup- port this recommendation. We examined the fea- sibility and effects of an exercise intervention upon quality of life and irritable bowel symptoms using a randomised controlled trial methodology. Patients with a clinically confirmed diagnosis of irritable bowel syndrome according to Rome II criteria were randomised to either an exercise consultation intervention or usual care for 12 weeks. Outcomes included irritable bowel specif- ic quality of life, symptoms (total symptoms, con- stipation, diarrhoea and pain) and exercise par- ticipation. The recruitment rate of eligible pa- tients identified from hospital records was 18.3% (56/305). Analyses revealed no differences in quality life scores between groups at 12-week follow-up. The exercise group reported sig- nificantly improved symptoms of constipation (mean difference = 10.9, 95%CI = – 20.1, – 1.6) compared to usual care at follow-up. The inter- vention group participated in significantly more exercise than usual care at follow-up (mean dif- ference = 21.6, 95% CI = 9.4, 33.8). Recruitment of eligible patients into this study was possible but rates were low. Findings highlight the possibility that exercise may be an effective intervention for symptom management in patients with irritable bowel syndrome; this may be particularly the case for constipation predominant patients. The Effects of Exercise upon Symptoms and Quality of Life in Patients Diagnosed with Irritable Bowel Syndrome: A Randomised Controlled Trial Authors A. J. Daley 1 , C. Grimmett 2 , L. Roberts 1 , S. Wilson 1 , M. Fatek 3 , A. Roalfe 1 , S. Singh 4 Affiliations 1 Primary Care and General Practice, University of Birmingham, Birmingham, United Kingdom 2 Health Behaviour Unit, University College London, London, United Kingdom 3 Warneford Hospital, City Central CMHT, Oxford, United Kingdom 4 Good Hope Hospital, Good Hope Hospital, Sutton Coldfield, United Kingdom Key words l " exercise l " quality of life l " IBS l " constipation l " diarrhoea accepted after revision March 17, 2008 Bibliography DOI 10.1055/s-2008-1038600 Published online 2008 Int J Sports Med © Georg Thie- me Verlag KG Stuttgart • New York • ISSN 0172-4622 Correspondence Dr. Amanda J. Daley University of Birmingham Primary Care and General Practice Clinical Sciences Building, Edgbaston B15 2TT Birmingham United Kingdom Phone: + 0 12 14 14 37 62 Fax: + 0 12 14 14 37 62 a.daley@bham.ac.uk Daley AJ et al. The Effects of … Int J Sports Med Behavioural Sciences