Participants in this group will practice autogenic relaxation training with aerobic exercise and lifestyle modification. The Intervention will last for 8 weeks, with autogenic relaxation training sessions conducted one time per week under physiotherapist's supervision. In addition, aerobic exercise will be three sessions per week for 8 weeks.

Participants in this group will receive aerobic exercise and lifestyle modification. Aerobic exercise will be three sessions per week for 8 weeks.

The six standard exercises in autogenic relaxation training cause the body to feel calm, warm, and heavy. Each exercise involves the patient lying down, focusing without any particular objective, and then using verbal cues and visual imagination to relax her body in a particular way. The woman relaxed in a half-lying position with a supported back and both arms relaxed at her sides during the eight-week autogenic relaxation training, which lasted 30-40 minutes, one session each week. The woman was advised to focus on her breathing and identify if it was shallow or rapid. Then start to visualize anything in her thoughts. This item should be easy for her to use and enjoyable.

The IBS-SSS is a valid and reliable patient-based measure that evaluates the severity of IBS symptoms through five clinically significant items over ten days, as follows: (1) frequency and (2) severity of abdominal pain; (3) degree of abdominal distention or tightness; (4) dissatisfaction with bowel habits; and (5) affection of IBS on quality of life. A greater score denotes worse conditions. Each item is rated on a visual analog scale (VAS) from 0 to 100, resulting in an overall score ranging from 0 to 500. Based on the data collected, the IBS-SSS scores are divided into three categories: mild symptoms (from 75 to 174), moderate symptoms (from 175 to 299), and severe symptoms (from 300 to 500). Additionally, a 95-point reduction in total IBS-SSS scores is clinically meaningful, indicating an improvement in symptoms.

Complete spontaneous bowel movement is defined as a sense of complete evacuation without laxatives, enemas, or suppositories on the day of the bowel movement or the preceding day. A participant with a weekly complete spontaneous bowel movement frequency rate of three or more and an increase of one or more from baseline is considered a responder. The patients reported the number of their complete spontaneous bowel movements per week at baseline, post-intervention and one month later. The minimal clinically important change in the number of complete spontaneous bowel movements is 1.3 times per week.

The Arabic version of the questionnaire will be used. The 21 items in the MFIS are divided into three categories: physical (nine items), cognitive (10 items), and psychosocial (two items). For all items, participants rate their agreement using a 5-point Likert scale, where 0 means "never" and 4 means "almost always." The total score (0-84) comprises sub-scores for physical (0-36), cognitive (0-40), and psychosocial (0-8) functioning. A greater score is worse.