Chai J, Wang ZY, Weng ZJ, Zhang ZJ, Wu LY, Zhang F, Cao LL, Chen ZY, Wu HG, Liu HR. Role of physical therapy in irritable bowel syndrome: Current strategies and prospective options. World J Gastroenterol 2026; 32(29): 118105 [DOI: 10.3748/wjg.118105]
Corresponding Author of This Article
Hui-Rong Liu, Professor, Shanghai Institute of Acupuncture and Meridian Research, Shanghai University of Traditional Chinese Medicine, No. 650 South Wanping Road, Shanghai 200030, China. lhr_tcm@139.com
Research Domain of This Article
Genetics & Heredity
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review-article
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Chai J, Wang ZY, Weng ZJ, Zhang ZJ, Wu LY, Zhang F, Cao LL, Chen ZY, Wu HG, Liu HR. Role of physical therapy in irritable bowel syndrome: Current strategies and prospective options. World J Gastroenterol 2026; 32(29): 118105 [DOI: 10.3748/wjg.118105]
Jing Chai, Zhen-Yi Wang, Zi-Jun Zhang, Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
Zhi-Jun Weng, Lu-Yi Wu, Fang Zhang, Lu-Lu Cao, Zi-Yi Chen, Huan-Gan Wu, Hui-Rong Liu, Shanghai Institute of Acupuncture and Meridian Research, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
Author contributions: Chai J conceived and drafted the manuscript; Wang ZY and Weng ZJ contributed to the literature search and manuscript revision; Zhang ZJ, Wu LY, Zhang F, Cao LL, and Chen ZY contributed to the literature collection and interpretation; Wu HG assisted in organizing the structure of the review and refining the arguments; Liu HR designed and supervised the work and critically revised the manuscript for important intellectual content. All authors have read and approved the final version of the manuscript.
AI contribution statement: ChatGPT or similar AI tools are only used for limited language polishing and grammar correction during the manuscript preparation process. The main text of the manuscript (including the abstract, introduction, and all review sections) is written and revised by the author. No part of the scientific content in the manuscript is generated by AI. The AI tools are only used for language editing and improving readability. They are not used for literature selection, data analysis, content generation or manuscript writing. The AI tools did not participate in the design of the review framework, literature interpretation or the formulation of scientific conclusions. Any images, charts or graphic materials included in the manuscript were not generated by artificial intelligence. All authors are fully responsible for the originality, accuracy and completeness of the manuscript.
Supported by National Natural Science Foundation of China, No. 82374588; Special Project for Smart Healthcare of Shanghai Municipal Health Commission, No. 2025ZHYL016; Medical New Technology Research and Transformation Seed Project of Shanghai Municipal Health Commission, No. 2024ZZ2060; and Science and Technology Innovation Action Plan Rising-Star (Sailing Program) of Shanghai, No. 23YF1442100.
Conflict-of-interest statement: The authors declare no conflict of interest in the present report.
Corresponding author: Hui-Rong Liu, Professor, Shanghai Institute of Acupuncture and Meridian Research, Shanghai University of Traditional Chinese Medicine, No. 650 South Wanping Road, Shanghai 200030, China. lhr_tcm@139.com
Received: December 24, 2025 Revised: January 21, 2026 Accepted: April 13, 2026 Published online: August 7, 2026 Processing time: 206 Days and 1.1 Hours
Abstract
Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by dysregulation of the gut-brain interaction. It has a high global prevalence, significantly impairs quality of life, and imposes a substantial socioeconomic burden. The pathophysiology of IBS is complex and not yet fully elucidated, with its heterogeneity reflecting the interplay of multiple factors, including abnormal gastrointestinal motility, visceral hypersensitivity, gut microbiota dysbiosis, low-grade inflammation, and central nervous system dysfunction. This mechanistic complexity not only accounts for the highly individualized symptom profile of IBS but also highlights the limitations of monotherapy in addressing the long-term management needs of patients. Given the limited efficacy, frequent adverse effects, and insufficient adaptability of pharmacological treatments to the heterogeneity of IBS, non-pharmacological interventions have increasingly attracted attention. Among these, physical therapies - using electrical, magnetic, thermal, photic, or mechanical stimulation - can modulate neural activity at central, peripheral, and autonomic levels and have shown promising potential in alleviating IBS symptoms. The underlying mechanisms of physical therapies for IBS are proposed to involve neural modulation, visceral sensory regulation, immunoinflammatory control, and optimization of gut-brain axis function, representing a multi-system, synergistic mode of action. This narrative review synthesizes and contextualizes recent advances in emerging physical therapies for IBS, with a focus on clinical efficacy, safety, and feasibility, while discussing their potential mechanisms within a unified theoretical framework. The current limitations of the evidence, including small sample sizes, inconsistent intervention parameters, and insufficient mechanistic validation, are also addressed. Finally, future research directions are proposed, encompassing mechanism-driven clinical studies, standardization of intervention parameters, and high-quality randomized controlled trials. Overall, physical therapy offers a non-pharmacological, multi-mechanistic intervention capable of modulating multiple physiological systems.
Core Tip: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by impaired brain-gut communication, visceral hypersensitivity, immune activation, and autonomic imbalance. Physical therapies - including electrical stimulation, acupuncture, and mechanotherapy - have shown potential in modulating these interconnected pathways. This review discusses the neuromodulatory and anti-inflammatory mechanisms underlying physical therapy, highlighting its capacity to reduce abdominal pain, normalize bowel motility, and restore gut-brain homeostasis. By concurrently targeting multiple physiological systems, physical therapy represents a multi-mechanistic, non-pharmacological approach for IBS, offering new strategies for symptom management and improving patients’ quality of life.
