Exploring the gut-exercise link: A systematic review of gastrointestinal disorders in physical activity

Table 10 Exercises contraindicated in specific gastrointestinal diseases

Gastrointestinal disease	Contraindicated exercises	Reason for contraindication	Recommended modifications
GERD	High-impact activities (e.g., running, jumping); core exercises involving bending or lying flat; vigorous activities post-meal	Increases intra-abdominal pressure, relaxing the LES and exacerbating reflux; promotes acid reflux during activity	Opt for moderate-intensity aerobic exercises (e.g., walking, cycling); avoid exercising on a full stomach
Peptic ulcers	High-intensity exercises (e.g., heavy lifting, vigorous core exercises)	Increases abdominal pressure, aggravating symptoms such as pain and nausea; can impair healing of gastric mucosa	Engage in low-impact activities (e.g., walking, swimming); avoid exercising in dehydrated conditions
GI cancer	Strenuous or prolonged endurance exercises; high-impact activities during active treatment	Exacerbate fatigue, reduce nutrient absorption, and impair recovery during chemotherapy/radiation	Low-intensity activities (e.g., walking, stretching); gradually increase exercise intensity post-treatment
Gallbladder diseases	High-intensity workouts during active inflammation or gallbladder attacks	Increase bile production and aggravate symptoms such as bloating and pain	Resume moderate-intensity activities gradually post-recovery
IBS	Vigorous exercises, especially during flare-ups; intense abdominal workouts	Worsen bloating, cramping, or diarrhea by over-stimulating gut motility	Start with low to moderate-intensity aerobic exercises (e.g., walking)
IBD	High-impact or strenuous exercises during active flares	Increase inflammation and exacerbate fatigue or symptoms	Perform light stretching, yoga, or Tai Chi during flare-ups
Diverticular disease	High-impact or abdominal-straining exercises during acute diverticulitis	Worsen inflammation or increase pressure on diverticula	Focus on low-impact exercises (e.g., yoga, walking) during recovery
GI bleeding	Prolonged endurance activities (e.g., marathon running); high-impact sports	Increase mucosal injury and worsen bleeding through ischemia or mechanical trauma	Engage in gentle, low-impact exercises (e.g., walking, Tai Chi) during recovery
Constipation	None contraindicated; focus should be on avoiding inactivity	Inactivity can worsen constipation by slowing gut motility	Include aerobic exercises (e.g., walking, jogging) and core strengthening (e.g., yoga, Pilates)

GERD: Gastroesophageal reflux disease; LES: Lower esophageal sphincter; GI: Gastrointestinal; IBS: Irritable bowel syndrome; IBD: Inflammatory bowel disease.