The effect of exercise on Irritable Bowel Syndrome related complaints in patients diagnosed with Fibromyalgia syndrome

Fibromyalgia is a disease whose cause is not clearly known and which causes complaints such as widespread tenderness and pain in the muscles, sleep disturbance, cognitive complaints and headache, accompanied by psychiatric problems and irritable bowel syndrome. Considering the etiology of fibromyalgia syndrome and accompanying comorbidities, it can be considered among the central sensitization syndromes. Although pharmacological treatments can be used in treatment, exercise is considered as one of the basic components of treatment. Irritable bowel syndrome is a functional gastrointestinal disease in which complaints such as abdominal pain and bloating associated with changes in stool frequency and shape are seen. There is no clear test or structural abnormality for the definitive diagnosis of irritable bowel syndrome. The etiology of IBS is not clearly understood, but changes in the brain-gut axis have been implicated. Non-pharmacological treatment methods are gaining popularity due to the uncertain effect levels and short duration of action of the drugs used in the treatment of IBS. One of the most important of these methods is exercise therapy. Physical activity can be used in the treatment of both diseases, it also reduces the level of stress and the level of pain associated with various diseases. Studies have shown that exercises such as strengthening, yoga, and tai chi have a positive effect on FMS complaints. Aerobic exercises, which can be used in the treatment of both diseases, have a high level of evidence. Among the aerobic exercises, it has been determined that especially fast-paced walking exercise is beneficial and patient compliance and continuity in this type of aerobic exercise is high. The aim of this study is to investigate the effects of aerobic fast-paced walking exercise on irritable bowel syndrome-related gastrointestinal complaints, generalized body pain and quality of life in patients with fibromyalgia syndrome and concomitant irritable bowel syndrome diagnosis. Three of 40 patients with FMS and IBS included in the study were excluded from the study because they could not complete the treatment and evaluation processes, and a total of 36 patients completed the study. The patients were divided into two groups as exercise and control groups. While the patients in the exercise group were given aerobic fast-paced walking exercise, the patients in the control group were asked to continue their pre-study physical activity levels. The first two weeks of the exercises of the patients in the exercise group were recommended as aerobic walking exercise on the center-based treadmill under the supervision of a doctor, and the next 6 weeks as a fast-paced walking home exercise program. Walking exercise was recommended at least 3 days a week, once a day, for at least 30 minutes, for a total of 8 weeks. The patients were evaluated in terms of IBS symptom severity level, quality of life and fibromyalgia complaints level twice, before the treatment (week 0) and at the end of the treatment (week 8). IBS symptom severity was evaluated with the IBS symptom severity scale (IBS-SSS), quality of life SF-36, and the level of fibromyalgia-related complaints using the fibromyalgia impact questionnaire (FIQ). In our study, no statistically significant difference was found between the mean scores of SF-36 quality of life parameters such as Physical Function, Physical Role Difficulty, Emotional Role Difficulty, Energy/Vivacity, Mental Health and General Health Perception scores in both the exercise and control groups in terms of 0th and 8th week evaluations. In the control group, there was no significant improvement in other sub-parameters of SF-36, irritable bowel syndrome symptom severity scale scores and fibromyalgia impact questionnaire scores between the first and last evaluation. A statistically significant improvement was found between the first and last evaluation in the Social Functioning and Pain parameters of quality of life in the exercise group. A statistically significant decrease was found in the comparison of the 0th and 8th week IBS-SSS scores of the patients included in the exercise group. Again, a significant improvement was found in the mean scores of the fibromyalgia impact questionnaire in the exercise group when the first and last evaluation were compared. Although we think that aerobic fast-paced walking exercise may have positive effects on quality of life, widespread body pain and gastrointestinal complaints in patients with irritable bowel syndrome and fibromyalgia syndrome, we believe that studies with longer follow-ups are needed to evaluate the long-term effects of exercise.