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Exercise and the Microbiota-Gut-Brain-Muscle Axis in Irritable Bowel Syndrome

Yıl 2025, Cilt: 3 Sayı: 1, 1 - 5, 06.05.2025

Öz

Irritable bowel syndrome (IBS) is a common functional gastrointestinal condition marked by abdominal discomfort and irregular bowel movements. It is frequently associated with psychological symptoms and disturbances in gut microbiota. In recent years, attention has turned to the interconnected nature of the gut, brain, and skeletal muscle, described as the microbiota-gut-brain-muscle (MGB) axis. This review examines how exercise may support the management of IBS by influencing microbial composition, strengthening the intestinal barrier, regulating inflammation, and affecting neural pathways. Moderate aerobic exercise appears to ease gastrointestinal symptoms and enhance mental well-being, partly through immune and hormonal interactions. Current research suggests that mechanisms like myokine release, improved autonomic regulation, and vagal nerve activity may significantly influence IBS-related outcomes. Both controlled trials and real-world patient observations highlight the therapeutic value of tailored exercise interventions. Still, questions remain about how long-term exercise impacts the MGB axis, which warrants deeper exploration through future studies

Kaynakça

  • Afzaal, M., Saeed, F., Shah, Y. A., Hussain, M., Rabail, R., Socol, C. T., Hassoun, A., Pateiro, M., Lorenzo, J. M., Rusu, A. V., & Aadil, R. M. (2022). Human gut microbiota in health and disease: Unveiling the relationship. In Frontiers in Microbiology (Vol. 13). Frontiers Media S.A. https://doi.org/10.3389/fmicb.2022.999001
  • Allam, D. M. M., Ghaffar, H. A. A., Elshamy, A. M., Safa, M. A., & Ahmad, A. M. (2024). Effect of Pilates exercises on symptoms of irritable bowel syndrome in women: a randomized controlled trial. Archives of Physiotherapy, 14(1), 170–181. https://doi.org/10.33393/aop.2024.3228
  • Bianco, A., Russo, F., Franco, I., Riezzo, G.,Donghia, R., Curci, R., Bonfiglio, C., Prospero, L., D’Attoma, B., Ignazzi, A., Campanella, A., & Osella, A. R. (2023). Enhanced Physical Capacity and Gastrointestinal Symptom Improvement in Southern Italian IBS Patients Jollowing Three Months of Moderate Aerobic Exercise. Journal of Clinical Medicine, 12(21). https://doi.org/10.3390/jcm12216786
  • Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: trends, predictions and risk factors. In Nature Reviews Gastroenterology and Hepatology (Vol. 17, Issue 8, pp. 473–486). Nature Research. https://doi.org/10.1038/s41575-020-0286-8
  • Blake, M. R., Raker, J. M., & Whelan, K. (2016). Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 44(7), 693–703. https://doi.org/10.1111/apt.13746 Canavan, C., West, J., & Card, T. (2014). The epidemiology of irritable bowel syndrome. In Clinical Epidemiology (Vol. 6, Issue 1, pp. 71–80). https://doi.org/10.2147/CLEP.S40245
  • Carabotti, M., Scirocco, A., Antonietta Maselli, M., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems (Vol. 28).
  • Chaudhry, T. S., Senapati, S. G., Gadam, S., Mannam, H. P. S. S., Voruganti, H. V., Abbasi, Z., Abhinav, T., Challa, A. B., Pallipamu, N., Bheemisetty, N., & Arunachalam, S. P. (2023). The Impact of Microbiota on the Gut–Brain Axis: Examining the Complex Interplay and
  • Implications. In Journal of Clinical Medicine (Vol. 12, Issue16). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/jcm12165231 Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut Microbiota’s Effect on Mental Health: The Gut-Brain Axis. Clinics and Practice, 7(4), 987. https://doi.org/10.4081/cp.2017.987
  • Daniela, M., Catalina, L., Ilie, O., Paula, M., Daniel-Andrei, I., & Ioana, B. (2022). Effects of Exercise Training on the Autonomic Nervous System with a Focus on Anti-Inflammatory and Antioxidants Effects. In Antioxidants (Vol. 11, Issue 2). MDPI. https://doi.org/10.3390/antiox11020350
  • Dicks, L. M. T. (2022). Gut Bacteria and Neurotransmitters. In Microorganisms (Vol. 10, Issue 9). MDPI. https://doi.org/10.3390/microorganisms10091838
  • Fani, M., Mostamand, J., Fani, M., Chitsaz, N., & Feizi, A. (2019). The effect of aerobic exercises among women with mild and moderate irritable bowel syndrome: A pilot study. Journal of Bodywork and Movement Therapies, 23(1), 161–165. https://doi.org/10.1016/j.jbmt.2018.02.003
  • Groenendijk, D. W., Witteman, B. J., & Mulder, B. C. (2022). The Experiences of Female IBS Patients Concerning Physical Activity as Treatment Modality: A Qualitative Study. Qualitative Health Research, 32(11), 1690–1700. https://doi.org/10.1177/10497323221110109
  • Hamaguchi, T., Tayama, J., Suzuki, M., Nakaya, N., Takizawa, H., Koizumi, K., Amano, Y., Kanazawa, M., & Fukudo, S. (2020). The effects of locomotor activity on gastrointestinal symptoms of irritable bowel syndrome among younger people: An observational study. PLoS ONE, 15(5). https://doi.org/10.1371/journal.pone.0234089
  • Hawley, J. A., Forster, S. C., & Giles, E. M. (2025). Exercise, Gut Microbiome, and Gastrointestinal Diseases: Therapeutic Impact and Molecular Mechanisms. Gastroenterology. https://doi.org/10.1053/j.gastro.2025.01.224 Johannesson, E., Simrén, M., Strid, H., Bajor, A., & Sadik, R. (2011). Physical activity improves symptoms in irritable bowel syndrome: A randomized controlled trial. American Journal of Gastroenterology, 106(5), 915–922. https://doi.org/10.1038/ajg.2010.480
  • Lewis, E. D., Antony, J. M., Crowley, D. C., Piano, A., Bhardwaj, R., Tompkins, T. A., & Evans, M. (2020). Efficacy of lactobacillus paracasei ha-196 and bifidobacterium longum R0175 in alleviating symptoms of irritable bowel syndrome (IBS): A randomized, placebocontrolled study. Nutrients, 12(4). https://doi.org/10.3390/nu12041159
  • Li, C., Li, J., Zhou, Q., Wang, C., Hu, J., & Liu, C. (2024). Effects of Physical Exercise on the Microbiota in Irritable Bowel Syndrome. In Nutrients (Vol. 16, Issue 16).
  • Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/nu16162657 Marginean, C. M., Popescu, M., Drocas, A. I., Cazacu, S. M., Mitrut, R., Marginean, I. C., Iacob, G. A., Popescu, M. S., Docea, A. O., & Mitrut, P. (2023). Gut–Brain Axis, Microbiota and Probiotics—Current Knowledge on Their Role in Irritable Bowel Syndrome: A Review. In Gastrointestinal Disorders (Vol. 5, Issue 4, pp. 517–535).
  • Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/gidisord5040043
  • Margolis, K. G., Cryan, J. F., & Mayer, E. A. (2021). The Microbiota-Gut-Brain Axis: From Motility to Mood. In Gastroenterology (Vol. 160, Issue 5, pp. 1486– 1501). W.B. Saunders. https://doi.org/10.1053/j.gastro.2020.10.066
  • Mishima, Y., & Ishihara, S. (2021). Enteric microbiota-mediated serotonergic signaling in pathogenesis of irritable bowel syndrome. In International Journal of Molecular Sciences (Vol. 22, Issue 19). MDPI. https://doi.org/10.3390/ijms221910235
  • Ni Lochlainn, M., Bowyer, R. C. E., Moll, J. M., García, M. P., Wadge, S., Baleanu, A. F., Nessa, A., Sheedy, A., Akdag, G., Hart, D., Raffaele, G., Seed, P. T., Murphy, C., Harridge, S. D. R., Welch, A. A., Greig, C., Whelan, K., & Steves, C. J. (2024). Effect of gut microbiome modulation on muscle function and cognition: the PROMOTe randomised controlled trial. Nature Communications, 15(1). https://doi.org/10.1038/s41467-024-46116-y
  • Parker, C. H., Naliboff, B. D., Shih, W., Presson, A. P., Videlock, E. J., Mayer, E. A., & Chang, L. (2019). Negative Events During Adulthood Are Associated With Symptom Severity and Altered Stress Response in Patients With Irritable Bowel Syndrome. Clinical Gastroenterology and Hepatology, 17(11), 2245–2252. https://doi.org/10.1016/j.cgh.2018.12.029
  • Rojas-Valverde, D., Bonilla, D. A., GómezMiranda, L. M., Calleja-Núñez, J. J., Arias, N., & MartínezGuardado, I. (2023). Examining the Interaction between Exercise, Gut Microbiota, and Neurodegeneration: Future
  • Research Directions. In Biomedicines (Vol. 11, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/biomedicines11082267
  • Ruegsegger, G. N., & Booth, F. W. (2018). Health benefits of exercise. Cold Spring Harbor Perspectives in Medicine, 8(7). https://doi.org/10.1101/cshperspect.a029694 Saponaro, F., Bertolini, A., Baragatti, R., Galfo, L., Chiellini, G., Saba, A., & D’Urso, G. (2024). Myokines and Microbiota: New Perspectives in the Endocrine Muscle–Gut Axis. In Nutrients (Vol. 16, Issue 23). Multidisciplinary
  • Digital Publishing Institute (MDPI). https://doi.org/10.3390/nu16234032 Yang, M., Kobyliak, N., Chen, L.-Y., Setiati, S., Ali, Y., Chew, W., Lim, Y. P., Lim, W. S., Chambers, E. S., Frost, G., & Wong, S. H. (n.d.). Gut-muscle crosstalk. A perspective on influence of microbes on muscle function.
  • Yao, M., Qu, Y., Zheng, Y., & Guo, H. (2025). The effect of exercise on depression and gut microbiota: Possible mechanisms. In Brain Research Bulletin (Vol. 220). Elsevier Inc. https://doi.org/10.1016/j.brainresbull.2024.111130 Yuan, C., He, Y., Xie, K., Feng, L., Gao, S., & Cai, L. (2023). Review of microbiota gut brain axis and innate immunity in inflammatory and infective diseases. In Frontiers in Cellular and Infection Microbiology (Vol. 13). Frontiers Media SA. https://doi.org/10.3389/fcimb.2023.1282431
  • Zhao, S. R., Ni, X. M., Zhang, X. A., & Tian, H. (2019). Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrheapredominant irritable bowel syndrome patients. World Journal of Clinical Cases, 7(21), 3446–3462. https://doi.org/10.12998/wjcc.v7.i21.3446

İrritabl Bağırsak Sendromunda Egzersiz ve Mikrobiyota-Bağırsak-Beyin-Kas Aksı

Yıl 2025, Cilt: 3 Sayı: 1, 1 - 5, 06.05.2025

Öz

İrritabl bağırsak sendromu (İBS), karın rahatsızlığı ve düzensiz bağırsak alışkanlıkları ile karakterize edilen yaygın bir fonksiyonel gastrointestinal bozukluktur. Psikolojik semptomlar ve bağırsak mikrobiyotasındaki bozulmalar bu tabloya sıklıkla eşlik eder. Son yıllarda, bağırsak, beyin ve iskelet kası arasındaki karşılıklı ilişkileri tanımlayan mikrobiyota bağırsak–beyin–kas (MGB) aksı kavramı giderek daha fazla dikkat çekmektedir. Bu derlemede, egzersizin mikrobiyal bileşimi etkilemesi, bağırsak bariyerini güçlendirmesi, inflamasyonu düzenlemesi ve sinirsel yollar üzerindeki etkileri üzerinden İBS yönetimindeki potansiyel rolü ele alınmaktadır. Orta şiddette aerobik egzersizin, bağışıklık ve hormonal etkileşimler aracılığıyla gastrointestinal semptomları hafifletip psikolojik iyilik halini artırabileceği, bağışıklık ve hormonal etkileşimler yoluyla kısmen açıklanabilmektedir. Güncel araştırmalar, myokin salınımı, otonom sinir sistemi düzenlenmesinin iyileştirilmesi ve vagus siniri aktivitesi gibi mekanizmaların İBS ile ilişkili sonuçlar üzerinde önemli etkiler oluşturabileceğini göstermektedir. Hem kontrollü klinik çalışmalar hem de gerçek yaşamdan elde edilen hasta gözlemleri, bireyselleştirilmiş egzersiz müdahalelerinin terapötik değerini ortaya koymaktadır. Bununla birlikte, uzun süreli egzersizin MGB aksı üzerindeki etkilerine dair sorular halen yanıtlanmamış olup bu konunun gelecekte daha kapsamlı araştırmalarla ele alınması gerekmektedir

Kaynakça

  • Afzaal, M., Saeed, F., Shah, Y. A., Hussain, M., Rabail, R., Socol, C. T., Hassoun, A., Pateiro, M., Lorenzo, J. M., Rusu, A. V., & Aadil, R. M. (2022). Human gut microbiota in health and disease: Unveiling the relationship. In Frontiers in Microbiology (Vol. 13). Frontiers Media S.A. https://doi.org/10.3389/fmicb.2022.999001
  • Allam, D. M. M., Ghaffar, H. A. A., Elshamy, A. M., Safa, M. A., & Ahmad, A. M. (2024). Effect of Pilates exercises on symptoms of irritable bowel syndrome in women: a randomized controlled trial. Archives of Physiotherapy, 14(1), 170–181. https://doi.org/10.33393/aop.2024.3228
  • Bianco, A., Russo, F., Franco, I., Riezzo, G.,Donghia, R., Curci, R., Bonfiglio, C., Prospero, L., D’Attoma, B., Ignazzi, A., Campanella, A., & Osella, A. R. (2023). Enhanced Physical Capacity and Gastrointestinal Symptom Improvement in Southern Italian IBS Patients Jollowing Three Months of Moderate Aerobic Exercise. Journal of Clinical Medicine, 12(21). https://doi.org/10.3390/jcm12216786
  • Black, C. J., & Ford, A. C. (2020). Global burden of irritable bowel syndrome: trends, predictions and risk factors. In Nature Reviews Gastroenterology and Hepatology (Vol. 17, Issue 8, pp. 473–486). Nature Research. https://doi.org/10.1038/s41575-020-0286-8
  • Blake, M. R., Raker, J. M., & Whelan, K. (2016). Validity and reliability of the Bristol Stool Form Scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 44(7), 693–703. https://doi.org/10.1111/apt.13746 Canavan, C., West, J., & Card, T. (2014). The epidemiology of irritable bowel syndrome. In Clinical Epidemiology (Vol. 6, Issue 1, pp. 71–80). https://doi.org/10.2147/CLEP.S40245
  • Carabotti, M., Scirocco, A., Antonietta Maselli, M., & Severi, C. (2015). The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems (Vol. 28).
  • Chaudhry, T. S., Senapati, S. G., Gadam, S., Mannam, H. P. S. S., Voruganti, H. V., Abbasi, Z., Abhinav, T., Challa, A. B., Pallipamu, N., Bheemisetty, N., & Arunachalam, S. P. (2023). The Impact of Microbiota on the Gut–Brain Axis: Examining the Complex Interplay and
  • Implications. In Journal of Clinical Medicine (Vol. 12, Issue16). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/jcm12165231 Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut Microbiota’s Effect on Mental Health: The Gut-Brain Axis. Clinics and Practice, 7(4), 987. https://doi.org/10.4081/cp.2017.987
  • Daniela, M., Catalina, L., Ilie, O., Paula, M., Daniel-Andrei, I., & Ioana, B. (2022). Effects of Exercise Training on the Autonomic Nervous System with a Focus on Anti-Inflammatory and Antioxidants Effects. In Antioxidants (Vol. 11, Issue 2). MDPI. https://doi.org/10.3390/antiox11020350
  • Dicks, L. M. T. (2022). Gut Bacteria and Neurotransmitters. In Microorganisms (Vol. 10, Issue 9). MDPI. https://doi.org/10.3390/microorganisms10091838
  • Fani, M., Mostamand, J., Fani, M., Chitsaz, N., & Feizi, A. (2019). The effect of aerobic exercises among women with mild and moderate irritable bowel syndrome: A pilot study. Journal of Bodywork and Movement Therapies, 23(1), 161–165. https://doi.org/10.1016/j.jbmt.2018.02.003
  • Groenendijk, D. W., Witteman, B. J., & Mulder, B. C. (2022). The Experiences of Female IBS Patients Concerning Physical Activity as Treatment Modality: A Qualitative Study. Qualitative Health Research, 32(11), 1690–1700. https://doi.org/10.1177/10497323221110109
  • Hamaguchi, T., Tayama, J., Suzuki, M., Nakaya, N., Takizawa, H., Koizumi, K., Amano, Y., Kanazawa, M., & Fukudo, S. (2020). The effects of locomotor activity on gastrointestinal symptoms of irritable bowel syndrome among younger people: An observational study. PLoS ONE, 15(5). https://doi.org/10.1371/journal.pone.0234089
  • Hawley, J. A., Forster, S. C., & Giles, E. M. (2025). Exercise, Gut Microbiome, and Gastrointestinal Diseases: Therapeutic Impact and Molecular Mechanisms. Gastroenterology. https://doi.org/10.1053/j.gastro.2025.01.224 Johannesson, E., Simrén, M., Strid, H., Bajor, A., & Sadik, R. (2011). Physical activity improves symptoms in irritable bowel syndrome: A randomized controlled trial. American Journal of Gastroenterology, 106(5), 915–922. https://doi.org/10.1038/ajg.2010.480
  • Lewis, E. D., Antony, J. M., Crowley, D. C., Piano, A., Bhardwaj, R., Tompkins, T. A., & Evans, M. (2020). Efficacy of lactobacillus paracasei ha-196 and bifidobacterium longum R0175 in alleviating symptoms of irritable bowel syndrome (IBS): A randomized, placebocontrolled study. Nutrients, 12(4). https://doi.org/10.3390/nu12041159
  • Li, C., Li, J., Zhou, Q., Wang, C., Hu, J., & Liu, C. (2024). Effects of Physical Exercise on the Microbiota in Irritable Bowel Syndrome. In Nutrients (Vol. 16, Issue 16).
  • Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/nu16162657 Marginean, C. M., Popescu, M., Drocas, A. I., Cazacu, S. M., Mitrut, R., Marginean, I. C., Iacob, G. A., Popescu, M. S., Docea, A. O., & Mitrut, P. (2023). Gut–Brain Axis, Microbiota and Probiotics—Current Knowledge on Their Role in Irritable Bowel Syndrome: A Review. In Gastrointestinal Disorders (Vol. 5, Issue 4, pp. 517–535).
  • Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/gidisord5040043
  • Margolis, K. G., Cryan, J. F., & Mayer, E. A. (2021). The Microbiota-Gut-Brain Axis: From Motility to Mood. In Gastroenterology (Vol. 160, Issue 5, pp. 1486– 1501). W.B. Saunders. https://doi.org/10.1053/j.gastro.2020.10.066
  • Mishima, Y., & Ishihara, S. (2021). Enteric microbiota-mediated serotonergic signaling in pathogenesis of irritable bowel syndrome. In International Journal of Molecular Sciences (Vol. 22, Issue 19). MDPI. https://doi.org/10.3390/ijms221910235
  • Ni Lochlainn, M., Bowyer, R. C. E., Moll, J. M., García, M. P., Wadge, S., Baleanu, A. F., Nessa, A., Sheedy, A., Akdag, G., Hart, D., Raffaele, G., Seed, P. T., Murphy, C., Harridge, S. D. R., Welch, A. A., Greig, C., Whelan, K., & Steves, C. J. (2024). Effect of gut microbiome modulation on muscle function and cognition: the PROMOTe randomised controlled trial. Nature Communications, 15(1). https://doi.org/10.1038/s41467-024-46116-y
  • Parker, C. H., Naliboff, B. D., Shih, W., Presson, A. P., Videlock, E. J., Mayer, E. A., & Chang, L. (2019). Negative Events During Adulthood Are Associated With Symptom Severity and Altered Stress Response in Patients With Irritable Bowel Syndrome. Clinical Gastroenterology and Hepatology, 17(11), 2245–2252. https://doi.org/10.1016/j.cgh.2018.12.029
  • Rojas-Valverde, D., Bonilla, D. A., GómezMiranda, L. M., Calleja-Núñez, J. J., Arias, N., & MartínezGuardado, I. (2023). Examining the Interaction between Exercise, Gut Microbiota, and Neurodegeneration: Future
  • Research Directions. In Biomedicines (Vol. 11, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/biomedicines11082267
  • Ruegsegger, G. N., & Booth, F. W. (2018). Health benefits of exercise. Cold Spring Harbor Perspectives in Medicine, 8(7). https://doi.org/10.1101/cshperspect.a029694 Saponaro, F., Bertolini, A., Baragatti, R., Galfo, L., Chiellini, G., Saba, A., & D’Urso, G. (2024). Myokines and Microbiota: New Perspectives in the Endocrine Muscle–Gut Axis. In Nutrients (Vol. 16, Issue 23). Multidisciplinary
  • Digital Publishing Institute (MDPI). https://doi.org/10.3390/nu16234032 Yang, M., Kobyliak, N., Chen, L.-Y., Setiati, S., Ali, Y., Chew, W., Lim, Y. P., Lim, W. S., Chambers, E. S., Frost, G., & Wong, S. H. (n.d.). Gut-muscle crosstalk. A perspective on influence of microbes on muscle function.
  • Yao, M., Qu, Y., Zheng, Y., & Guo, H. (2025). The effect of exercise on depression and gut microbiota: Possible mechanisms. In Brain Research Bulletin (Vol. 220). Elsevier Inc. https://doi.org/10.1016/j.brainresbull.2024.111130 Yuan, C., He, Y., Xie, K., Feng, L., Gao, S., & Cai, L. (2023). Review of microbiota gut brain axis and innate immunity in inflammatory and infective diseases. In Frontiers in Cellular and Infection Microbiology (Vol. 13). Frontiers Media SA. https://doi.org/10.3389/fcimb.2023.1282431
  • Zhao, S. R., Ni, X. M., Zhang, X. A., & Tian, H. (2019). Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrheapredominant irritable bowel syndrome patients. World Journal of Clinical Cases, 7(21), 3446–3462. https://doi.org/10.12998/wjcc.v7.i21.3446
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Fizyoterapi
Bölüm DERLEME MAKALE
Yazarlar

Nilgün Çırak 0009-0005-2196-9069

Cahidenur Koçak 0000-0003-3362-2415

Yayımlanma Tarihi 6 Mayıs 2025
Gönderilme Tarihi 20 Nisan 2025
Kabul Tarihi 29 Nisan 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 3 Sayı: 1

Kaynak Göster

APA Çırak, N., & Koçak, C. (2025). Exercise and the Microbiota-Gut-Brain-Muscle Axis in Irritable Bowel Syndrome. İstanbul Esenyurt Üniversitesi Sağlık Bilimleri Dergisi, 3(1), 1-5.