Fortunately, the GI Research Foundation at the University of Chicago has launched a series of guided yoga, meditation, and breath-work classes online. The classes cater to all experience levels and include IBD-focused content — such as a quick, three-minute meditation for symptom relief and a five-minute breathing exercise for pain relief — as well as two 40-minute video yoga classes, a meditation audio class, and guided breath work. The program was codesigned by Biana Lanson, MD, a physician in Stamford, Connecticut, who has ulcerative colitis (UC) and serves on the GI Research Foundation board of directors. According to Dr. Lanson, patients who integrate mind-body exercises such as yoga, meditation, and breath work as part of their IBD therapies report greater improvements in anxiety and pain compared with patients using medical interventions alone. “Unfortunately, this information is rarely brought up during a conventional GI patient visit,” says Lanson. “Our website introduces a key tool that physicians and patients can use to complement medical treatment.” While the online classes and tutorials are great for anyone isolating or socially distancing because of COVID-19, they also make it easier for people who struggle with IBD to incorporate mind-body therapies from the comfort of their home, especially during a flare. Lanson says she worked with the GI Research Foundation and her own doctor to create a safe and free way for all types of IBD patients to access the benefits of yoga and meditation. “As an IBD patient and a physician, I found my first yoga classes daunting, and I was skeptical that yoga and meditation could help me,” says Lanson, who now attends regular yoga classes. “I wanted to introduce this therapy to other IBD patients.” The program teaches patients the basics of yoga and meditation with the goal of inspiring them to explore additional videos, audio recordings, or local classes on their own, says Lanson. “For gastroenterologists, the exercises represent a new tool that empowers patients, based on ever-increasing clinical evidence of success,” she says.
Yoga Reduces Stress, Improves Outlook, and May Reduce IBD Pain
There is indeed a growing body of research that supports the benefits of integrating mind-body therapy into IBD treatment, and both the Mayo Clinic and the Crohn’s & Colitis Foundation recommend yoga and other mind-body therapies as a way to help patients cope with IBD. This is partly because of the relaxing effect these therapies have, especially when used over time. According to Michigan Medicine, the health system of the University of Michigan in Ann Arbor, deep breathing is one of the best ways to reduce stress because it mimics the way the body acts when relaxed. Deep breathing slows the parasympathetic nervous system — sometimes called the rest and digest system — which slows heart rate and relaxes muscles in the gastrointestinal tract. By itself, stress does not cause IBD, but it can make symptoms worse, says Laura Raffals, MD, a gastroenterologist at the Mayo Clinic in Rochester, Minnesota. Research has shown that yoga and mindfulness exercises have a significant effect on lowering stress. According to a review published in June 2020 in the American Journal of Gastroenterology, perceived stress, which may include anticipating an accident or discomfort before it actually occurs, can trigger IBD flares. In a review of studies published in April 2022 in Crohn’s & Colitis 360, a journal of the Crohn’s & Colitis Foundation, researchers determined that yoga is an effective therapy to improve quality of life and reduce stress and anxiety in people with IBD. A yoga practice may also reduce symptoms of UC. A small study published in the June 2017 issue of Alimentary Pharmacology & Therapeutics compared health outcomes for UC patients who practiced guided 90-minute yoga classes 12 times weekly with those who followed written self-care advice. After six months, the patients who practiced guided yoga had less UC activity than those in the written advice group. Another study, published in April 2020 in Scientific Reports, found that mindfulness-based therapies, including mindful breathing and guided meditation, improved inflammatory biomarkers in people with IBD. “Our field is finally beginning to fully appreciate the importance and benefits of a holistic approach to the care of our patients, which includes nutrition, movement, and mindfulness practices,” says Dr. Raffals. “Yoga and breath exercises are both great practices for our IBD patients to incorporate into their daily lives.” Yoga and mindfulness can also help shape the way people living with chronic disease view their diagnosis. A comparative study published in May 2019 in the journal Medical Science Monitor Basic Research looked at more than 400 people living with chronic disease. The group included 150 people who regularly practiced yoga. Researchers found that the people in this cohort tended to have a more positive perception of their disease and better well-being overall than those who did not regularly practice yoga. According to the study’s authors, the way a person perceives their illness can influence self-management behaviors, and patients who have a negative perception of their illness tend to have worse health outcomes. “During a flare, low-impact exercise such as walking, cycling, or yoga are great options to keep moving without too much stress on your body,” says Raffals. “Movement of any kind can help patients feel better overall and prevent complications from disease flares, such as blood clots.” On hard days, Lanson recommends starting with breath work or meditation before moving on to the GI Research Foundation’s 40-minute Restorative Practice yoga class, a gentle sequence designed to calm your nervous system and reduce symptoms. On days when patients are feeling stronger, she recommends the Active Practice, which includes poses that are designed to reduce stress, relax and strengthen the core, and rejuvenate the body. Regardless of the practice, the GI Research Foundation advises people who use the videos as part of their care to listen to their bodies and take a rest if the movements become uncomfortable. “Patients with IBD commonly seek complementary therapies to their conventional medical treatments, but have surprisingly few high quality and expertly produced options,” says Lanson. “Our website offers patients just that, an important tool to help manage their symptoms.”
