Yoga for IBS

Food * Mood * Mindfulness

Yoga, especially the looking within that yoga promotes, helps regulate the body and improve mood and physical functioning

The smooth functioning of digestion depends on the action of the autonomic nervous system, especially the parasympathetic branch (PNS), associated with relaxation and restoration.  Stress activates the sympathetic side (SNS), the fight or flight system, which can interfere with the bowels.

Exercise is known to lower stress levels.  Beyond this general effect of physical activity, specific yoga postures can offer help with a wide variety of IBS symptoms.  For example, people with constipation often benefit from gentle yoga stretches and twists, and if they are able, more vigorous poses like Sun Salutations and inversions.  Since stress can lead to both constipation and diarrhea, a variety of practices from asana to breathing exercises designed to calm down the SNS and shift the balance more toward the restorative PNS side of the equation, can facilitate balanced bowel function.

Serious students of yoga practice meditation techniques along with the physical practices (asana), as well as self-study (svadhyaya).  Self-study encourages figuring out what stressors are at play for the individual student, and whether there is a connection between them and symptoms.  Self-study also involves looking at the link between certain foods eaten and how they make the student feel.  Through self-study, if the student continues to eat the offending foods anyway, yoga suggests looking further to ascertain why that might be.  Keeping a yoga journal which includes diet, yoga practice, IBS symptoms, stressors and any other salient information can be instructive and helpful.

Yoga encourages the study of HOW the patient eats.  Rapid eating can be a contributor to IBS symptoms through the ingestion of air and inadequately chewed food, worsening gas and bloating.  The process of mindful (yogic) eating encourages slowing down, savoring each bite, being in the moment with food and our senses, and relaxing.  Bringing more yogic awareness to the entire process of eating can facilitate relaxation by making it more of a meditation.  The practitioner of yoga also can experience a multitude of other health benefits from adopting a more yogic lifestyle, including choosing healthier foods, limiting caffeine and alcohol, using asana practices as stress management, meditating to improve mood, and tuning in to the physical body in ways that invite symptom management.  Rather than plowing through life, anxiously rushing from one activity to another, inviting more anxiety through IBS flare ups, the practitioner can slow down, learn to say no to outside stressors, and watch anxious thoughts come and go.  A yoga practice is the perfect complement to therapy, meditation, and CAM management of IBS symptoms.

There is some scientific evidence for the benefits of yoga and IBS symptom improvement.  One example is of a RCT of 100 patients with IBS which was conducted in India in 1992.  Patients were divided into three groups; one group was given traditional drug treatment, one a yoga program, and one a combination of drugs and yoga.  The yoga intervention consisted of asana, pranayama (breathing), kriyas (yogic cleansing techniques), and mediation.  The drug therapy included anti-anxiety drugs, antispasmodics, and fiber supplements.  After two weeks of training, the groups were asked to practice 30 minutes per day for the next two months.   Both drugs and yoga used alone were effective in significantly reducing abdominal pain, constipation, diarrhea, anxiety, and other symptoms, with yoga generally more effective the medication.  The combination of yoga and modern drug therapy was consistently more effective than either modality alone, eliminating all symptoms within six weeks, with the benefits persisting at the conclusion of the study.

Due to the low risk of complications, the extensive benefits that yoga provides, as well as overall improvements in self-efficacy and body awareness which accompany a regular yoga practice, IBS patients would benefit from the development of a regular yoga practice tailored for IBS, designed by a competent, certified instructor.  Evidence based, researched yoga protocol for IBS can be found below.

Yoga also helps with anxiety in a number of ways.  It offers specific techniques that can reduce symptoms, both in the short and longer term.  Because of its focus on tuning in to inward states, yoga can also help one get beneath the surface of anxiety to figure out what is triggering it, including habitual though patterns or unresolved conflicts.  One of the key yogic techniques used to counter anxiety is to focus on the breath.  The connection between the mind and the breath is most obvious with anxiety.  When one is engaged in anxious, fearful, or stressful states, breathing is changed in a number of ways.  It can become choppy, restrained, shallow, rapid, or even stop altogether for periods of time.  In a calm state, breathing is smooth and rhythmic.

Yoga’s focus on deep abdominal breathing, which focuses on slower, more relaxed patterns, helps the anxious client.  Ironically, lifetime patterns of anxiety can lead to muscle tension restricting the abdominal muscles that circle the belly.  Anytime the belly can’t move freely, breathing is impaired.  Impaired breathing leads to anxiety, and chronic tightness in the intercostal muscles that lie in between the ribs can also impact the breath.  A regular practice of yoga including breath work (Pranayama) is an effective method of combating anxiety, according to scientific studies.  Voluntarily slowing the breath during periods of stress counters many of the physiological components of stress while reducing feelings of anxiety.  Techniques include increasing the length of exhalation relative to the inhalation, relaxed, diaphragmatic breathing, and other practices.

Yoga Practices Beneficial for IBS (Tavassoli, 2009)

 Pranayama (Breathing): A simple practice to begin with is to gently place the hands on the abdomen and breathe deeply, observing the movement of the abdomen. Alternate nostril breathing can also be practiced to balance the autonomic nervous system.

 Warm-Ups on Hands and Knees: Head-to-knee pose (alternating sides) helps to relieve abdominal bloating. Cat/cow, followed by balasana (child’s pose), can help relieve constipation and bloating.

Inversion: A gentle inversion, viparita karani (legs- up-the-wall pose), can be very relaxing both at the start of the session and again before final relaxation. It may be helpful in relieving symptoms of diarrhea.

Forward bends: Paschimottonasana (seated forward bend) and padahastasana (standing hands-to-feet pose) can help calm the nerves and relax the mind.

Back bends: Setu bandhasana (bridge pose) can help relieve abdominal cramps and diarrhea. Bhujangasana (cobra pose), shalabhasana (locust pose), and dhanurasana (bow pose) may encourage the circulation of blood to the abdominal organs and massage the abdominal organs. This can help relieve digestive complaints and constipation.

Twists and side bends: Twisting postures and side bends, including trikonasana (triangle pose), improve circulation to the abdominal organs. They help to improve digestion and can relieve constipation.

Relaxation: In savasana (corpse pose), a focus on deep abdominal breaths relaxes the whole body and mind. Observing the natural rise and fall of the abdomen with each breath and becoming aware of the abdominal organs enhances the relaxation effect. With each exhalation, the Yogi may mentally repeat, “I relax my abdominal organs [or belly]; my abdominal organs are relaxed”.

Tavassoli, S. (2009). Yoga and the management of IBS. International Journal of Yoga Therapy, 97-103.