Can yoga help IBS?
IBS has been my constant companion for over 3 decades. Abdominal pain, bloating, constipation, diarrhea and nausea.
I’ve tried every type of diet – high fibre, low fibre, low fat, low carb, low fodmap and low salicylates, along with prebiotics, probiotics, synbiotics, psychobiotics and antibiotics. In fact, I reckon I’ve spent the GDP of a small nation on pharmaceuticals, neutraceuticals and snake-oil.
So I tend to view new treatment therapies with more than a dose of scepticism. And after researching the benefits of yoga and IBS, I’ve learned two things:
1. there’s growing academic interest in yoga (and other relaxation techniques) to improve IBS and digestive health
2. scientists use the words ‘might’, ‘could’ and ‘potential’ a lot!
While the science falls short of endorsing yoga as an IBS therapy, the evidence base is growing. But the only way of finding out if yoga can help your IBS is to try it. This blog reviews the scientific evidence to date and provides a free 20-min yoga practice so you can find out yourself if yoga improves your IBS.
You don’t have to be a yogi to get the benefits
I LOVE people who do yoga. Seriously, they are some of the happiest and most content people I know. Sadly, I’m just not one of them.
I know I SHOULD love yoga and I’ve given it a red hot go in the past, but it’s just not for me. Or so I thought!
I used to find it slow and repetitive and the classes seemed so long. But after incorporating yoga into my regular workout sessions, I’m now a convert. While I’m not off to join a yoga retreat anytime soon, the science - and our friend Sara who you’ll meet in a minute - have convinced me that you don’t have to be a yogi to enjoy the gut health benefits.
There’s growing scientific evidence that yoga can have a positive impact on the gut brain axis and reduce functional GI symptoms. Plus, you don’t have to be a zen master to reap the rewards. It could be as simple as adding a few yoga poses to your post workout cool down or doing a few nightly poses while watching TV.
How does yoga help with IBS? (here’s the answer in a nutshell)
Scientists now believe that IBS is the result of miscommunication between the brain and the gut.
Yoga has both exercise and stress reduction benefits. And these could help with IBS through a range of pathways including a reduction in stress-induced activity of the parasympathethic nervous system and the interactions between the hypothalamus–pituitary and adrenal glands. In addition, yoga may improve symptoms through changes in immune function and inflammatory processes. But we’re still a long way from figuring out the full story.
If you’re looking for a more indepth explanation of the science, we’ve got you covered. Scroll to the bottom of the blog for a more indepth review of the latest clinical data.
Top 3 yoga movements for IBS relief
The main yoga movements for IBS are easy and manageable to achieve and involve three basic shapes – knees-to-chest, forward bends and twisting. Not a downward dog or headstand in sight!
1. Knees-to-chest
While lying on the floor, bring your knees into your chest and give them a hug. If you’re feeling particularly gassy, you might repeat this movement using one leg at a time – drawing one knee into the chest, hold and then repeat with the other knee.
2. Forward bends
If you’re super flexible, bending over to touch your toes allows you to fold in half so that the top half of your body meets the bottom half. Easily said if you’re a gymnast. If not, don’t panic. You can achieve the same effect while sitting in a chair. Just bend forward as far as you can comfortably go and breathe.
3. Twisting
Twisting your body has a wringing effect on the abdomen which can help move things along. You can try a seated spinal twist in a chair or on the floor. The aim is to twist your torso slowly to the left and hold and then repeat on the other side.
You could add these to your post-workout cool down or get into the habit of doing the 3 poses nightly while watching TV.
Got 20 minutes?
Sold on the benefits of yoga therapy and want to do more? Our friend Sara from The Mindful Peanut has put together a free 20-minute video for healthy digestion and IBS relief. It’s an easy sequence suitable for all levels of experience. Most of the poses are done while sitting or lying on the floor.
You don’t need any equipment - just a mat or towel if you don’t want to lie directly on the ground.
The reason I love Sara’s video is that it’s just 20 minutes – so you can get the benefits of yoga without signing up to a lengthy class. I’ve been able to integrate this practice easily into my gym routine. In fact, it’s a lovely way of ending a rigorous workout. You can find more about Sara and all her online yoga classes on her Mindful Peanut website.
How does yoga help with IBS? (the long scientific answer)
A systematic review headed by Dr. Dania Schumann, a nutritional scientist based in Germany, assessed the results of previous studies that explore the effectiveness of yoga as a treatment for IBS. The article, published in Clinical Gastroenterology and Hepatology in 2016, is the first of its kind - a review specifically investigating yoga practice in IBS management.
The findings suggest that yoga might be a feasible and safe secondary treatment for IBS.
There was some evidence to support the benefits of yoga, including significantly decreased bowel symptoms, IBS severity and anxiety. Furthermore, patients responded with significant improvements in quality of life and physical functioning after yoga compared with no treatment. But don’t go into a frenzy looking for a yoga instructor just yet…
Although there is reason to be optimistic, Schumann and colleagues concluded that NO recommendation could be made regarding yoga as a routine treatment for IBS patients. This is because of major flaws in their study methods, including:
the lack of findings on long-term effects
the risk of bias
the lack of reported safety data regarding adverse events
larger representation of female patients
So how did Schumann respond? By leading her own clinical trial, one year later.
The study, published in the Alimentary Pharmacology & Therapeutics medical journal, compares yoga with an emerging dietary treatment for IBS - the low FODMAP diet. It was conducted in the Faculty of Medicine at the University of Duisburg-Essen in Essen, Germany.
Both male and female patients, between 18 and 75 years old, were included if they had suffered from diagnosed IBS for at least 6 months. A total of 47 patients were randomly assigned to either yoga or nutritional counselling in conjunction with a low FODMAP diet.
The IBS Syndrome Severity Scoring system (IBS-SSS) was used to determine each patients’ symptom severity. Higher IBS-SSS scores indicates higher symptom severity. It is a self-reported questionnaire exploring:
the severity and frequency of patients’ pain
the degree of abdominal distension/bloating experienced
the extent to which their IBS symptoms interfere with their lives.
Schumann found that there was NO significant difference between the groups, with regard to their self-reported IBS-SSS score at either 12 or 24 weeks into the study. Both treatment options also showed a significant decrease in IBS symptom severity. One patient in each group experienced serious adverse effects, and another, also in each group, experienced non-serious adverse effects.
In conclusion, the study found that IBS patients benefited from BOTH yoga and a low fodmap diet, as both groups showed a reduction in gut health symptoms. (If you want to checkout the low fodmap diet check out this blog post.)
An updated systematic review conducted in 2019 (D’Silva, et al “Yoga as a Therapy for Irritable Bowel Syndrome”) found that yoga was more effective compared to pharmacological treatment and equally effective as diets or walking programs.
But overall the evidence is regarded as relatively low-quality due to the way the studies have been designed and conducted. And this stops researchers from being able to make specific recommendations about the use of yoga as therapy for IBS patients.
That said, if you’re convinced by the science but nervous about a trip to the yoga studio, try Sara’s 20-minute yoga practice for IBS peeps. That way, you can decide for yourself whether yoga helps your IBS. If you’re interested in keeping up to date with gut health research, sign up to our newsletter below.