EFFECTS OF REGULAR EXERCISE IN MANAGEMENT OF CHRONIC IDIOPATHIC CONSTIPATION

Regular physical exercise has long been considered in the management o f chronic constipation. This recommendation is probably based on the a ssumption that exercise shortens the transit time through the gastroin testinal tract. However, on the basis of previous studies, the effect of exercise on the transit remains controversial at best. Therefore, i t was the goal of the present study to assess the influence of regular physical exercise, what average people may consider routine exercise, in the management of chronic idiopathic constipation. The study popul ation consisted of eight patients, seven women and a man, with chronic idiopathic constipation. They were studied for six weeks, including t wo weeks of rest and four weeks of regular exercise. Patients had a su bmaximal exercise test, before and after the exercise period, to deter mine their rate of perceived exertion (RPE), the target heart rate, an d the intensity of exercise they can perform. In addition to their rou tine daily activities, they exercised 1 hr a day, five days a week acc ording to their performance at the initial exercise tolerance test. Th ey kept a daily activity log and maintained their normal dietary intak e during this period. The patients overall physical activity was asses sed by a pedometer. They also maintained a diary of the number and con sistency of their bowel movements and the amount of straining required for defecation. The impact of exercise on constipation was assessed b y utilizing an index that took into consideration all three parameters of bowel function. Results of the study revealed that patients covere d 1.8 +/- 0.33 and 3.24 +/- 0.28 miles/day in the rest period and duri ng the exercise period, respectively (P = 0.007). The intensity of exe rcise may have improved the level of training as reflected on the mean maximum time before and after exercise period (P = 0.039). This level of exercise did not improve their constipation indices, which were 9. 11 +/- 0.65 and 8.57 +/- 1.08 in the rest and exercise periods, respec tively (P 0.68). In conclusion, physical activity, to the extent that people consider ''regular exercise,'' does not play a role in the mana gement of chronic idiopathic constipation.