By Sim Sekhon & Sascha McMeekin
Mental stress and IBS are known to be linked in a relationship that flows in both directions. IBS symptoms can lead to stress and anxiety and stress and anxiety can increase IBS symptoms. Although it is not always clear which comes first, it is well known that managing stress levels can be a helpful strategy to reduce IBS symptoms and improve overall wellbeing. Medication can be an effective and necessary option for some IBS sufferers, however, others prefer to avoid medication. This is what brings us to Yoga.
Yoga is an ancient Ayurvedic practice that traditionally incorporates physical postures, breath-awareness and meditation for the mind. Yoga places emphasis on breath as an anchor into the present moment. The poses are really a doorway to a deeper level of inner awareness, allowing us to tune into the body, notice what’s going on, and stay present for ourselves. Classes combine a variety of postures ranging from restful to powerful stretches, accompanied by a breath-awareness practice, and finally, meditation. With that being said, the modern practice of yoga has evolved to also include fitness-based stretching routines alone.
How can Yoga can help your IBS?
Well, any action that provides some form of rest from a busy work or home schedule may improve IBS symptoms for a short time. But Yoga can provide you with life-long tools to help you manage your IBS. These include the powers of movement, breath, calm and awareness.
The power of movement
The influence of exercise on gut motility is that physical activity induces more frequent bowel movements and speeds up transit through the gut. This may be especially helpful for people experiencing constipation predominant IBS (IBS-C). In traditional yoga practice, many postures are said to have benefits in the gut.
For example:
o Twists stimulate the internal abdominal organs, helping to relieve constipation and
indigestion.
o Heart openers (backbends) strengthen abdominals, improve digestion and enhance gut
function.
o Compression stretches (knee to chest) massage the abdomen and internal organs, aiding
digestion and helping to release gas.
The power of breath
The simple act of noticing your breath is incredibly powerful in helping to combat mental stress. Mental stress can drain your energy, ruin your sleep and lower your mood. When we are stressed, our normal breathing is affected and becomes uneven, shallow, rapid, or is even held. Considering the role our breath has to play in keeping us alive, it makes sense that if we hold our breath or take shallow breaths, our body will receive less oxygen, which of course isn’t helpful. A state of stress also triggers our heart rate and blood pressure to increase which perpetuates the state of stress we are already in.
But as soon as we stop to observe our breath, and begin slowing it down by breathing deeply, the body immediately feels a sense of calm as oxygen moves deep inwards. Deep breathing encourages our nervous system to transition from a stressful ‘fight-or-flight’ state to a relaxing ‘rest-and-digest’ mode. In this mode, the intercostal and abdominal muscles of the abdomen relax and digestion increases, helping food to move through the gut.
The power of calm
With regular practice of breath-awareness, you will start to become aware of how your body responds to stimuli through changes in breath. With careful observation, you’ll start to notice which stimuli cause this response. You realize that through your breath, you can control how your body responds on a physiological level. You can calm yourself in stressful situations and relieve your mind from worry. You might stop to take just one long, deep breath, or you might stay with the breath a little longer - it doesn’t matter. Just know that your breath is a portable tool which can shift your energy at any time of day. If you can manage your mind, your gut will thank you for it.
The power of awareness
With any awareness practice, a stronger connection to self develops. Your ability to tune inside the body and notice what’s going on will strengthen with practice which will help you to notice your IBS symptoms early and take action to manage them. Through your breath you can also manage your mental stress in response to those symptoms. Once you are aware of how/what you are feeling and experiencing, you can choose to respond to yourself with acceptance, kindness and compassion.
The power of awareness can also be cultivated through mindful eating. Mindful eating is when we pay attention to the food eaten, how it looks, feels, smells and tastes. While eating, we notice the flavours, textures and other sensations in the body. Our eating automatically slows down. This allows time for digestion in the body and provides us with an opportunity to tune into the body, notice when we start feeling full or are satisfied, and stop eating.
This is the opposite of distracted eating (includes emotional eating and eating while doing other things i.e. watching TV, driving, studying), which can lead to eating quickly and overeating. How is this an issue in IBS? When we eat quickly we swallow more air which can lead to IBS symptoms such as abdominal pain, bloating and increased wind. Distracted eating can lead to inadvertently eating one of your trigger foods (for example, foods high in fermentable carbohydrates i.e. FODMAPS) or eating more of a particular food than you can tolerate.
Slowing down your pace of eating and paying attention to your senses at mealtimes is a powerful way to enhance your enjoyment at mealtimes, prevent overeating and IBS flare-ups.
What does the research say about Yoga and IBS?
Although many research studies have investigated the effects of yoga on IBS symptoms, the studies are all very different to one another which limits the conclusions that can be drawn from the research. Different yoga practices have been looked at (Hatha, Iyengar, Vivekananda), and compared to different medical therapies (loperamide, propantheline or diazepam), and diet and lifestyle therapies (fibre supplement, physical activity). These differences make it difficult to clearly understand the true nature of the relationship between yoga and IBS.
For now, there are not any specific evidence-based recommendations for people with IBS, however, there is evidence that yoga reduces stress, anxiety and depression. And that yoga reduces physical pain, and improves energy levels, muscular strength, and flexibility. Furthermore, people with IBS have reported that lifestyle changes such as improved stress and sleep levels can improve IBS symptoms.
The verdict
Yoga is safe and beneficial, and in all the ways mentioned above yoga offers so much more than simply a fitness-based stretching routine, especially for people with IBS.
Harness the power of yoga in 3 steps
1. Try out a yoga class run by a professional instructor so you can be safely instructed.
2. Start to notice your breath during the day. Is it deep or shallow? Observe it without judgement.
3. Slow down your pace of eating and engage all of your senses at mealtimes.
Note: Always seek advice from a medical professional if you are not normally active or have heart- or any predisposing conditions.
I pride myself on supporting my clients every step of the way, empowering them with the knowledge to eventually manage their IBS without my support. To enquire about the Master your IBS program click here.
References
D’Silva, A., MacQueen, G., Nasser, Y., Taylor, L. M., Vallance, J. K., & Raman, M. (2020). Yoga as a Therapy for Irritable Bowel Syndrome. In Digestive Diseases and Sciences (Vol. 65, Issue 9, pp. 2503–2514). Springer. https://doi.org/10.1007/s10620-019-05989-6
Patel, N., & Lacy, B. (2016). Does Yoga Help Patients With Irritable Bowel Syndrome? In Clinical Gastroenterology and Hepatology (Vol. 14, Issue 12, pp. 1732–1734). W.B. Saunders. https://doi.org/10.1016/j.cgh.2016.08.014
Chen, K. W., Berger, C. C., Manheimer, E., Forde, D., Magidson, J., Dachman, L., & Lejuez, C. W. (2012). Meditative therapies for reducing anxiety: A systematic review and meta-analysis of randomized controlled trials. In Depression and Anxiety (Vol. 29, Issue 7, pp. 545–562). John Wiley & Sons, Ltd. https://doi.org/10.1002/da.21964
Selvan, S. R., Kavuri, V., Selvan, P., Malamud, A., & Raghuram, N. (2015). Randomized clinical trial study of Yoga therapy for Irritable Bowel Syndrome (IBS). European Journal of Integrative Medicine, 7, 23. https://doi.org/10.1016/j.eujim.2015.09.058
Rocha, K. K. F., Ribeiro, A. M., Rocha, K. C. F., Sousa, M. B. C., Albuquerque, F. S., Ribeiro, S., & Silva, R. H. (2012). Improvement in physiological and psychological parameters after 6months of yoga practice. Consciousness and Cognition, 21(2), 843–850. https://doi.org/10.1016/j.concog.2012.01.014
Pascoe, M. C., & Bauer, I. E. (2015). A systematic review of randomised control trials on the effects of yoga on stress measures and mood. Journal of Psychiatric Research, 68, 270–282. https://doi.org/10.1016/j.jpsychires.2015.07.013