Irritable Bowel Syndrome and Yoga

by Baxter

As I am preparing for my upcoming web talks on Yoga for Healthy Digestion for YogaU Online scheduled for July 23rd and 25th, I am rediscovering a lot about  both our digestive health and illness. Of particular interest is a very common gastro-intestinal (GI) condition called Irritable Bowel Syndrome, sometimes abbreviated IBS. The last time statistics were taken for this condition in the US, it was estimated that 15.3 million people suffered with IBS. It accounted for three million doctors office visits in 2004, 212,000 hospitalizations the same year, and 5.9 million prescriptions. Before we look at yoga’s potential impact on IBS, let’s take a look at how IBS shows up and what we know about its causes. According to the Mayo Clinic website:

“Irritable bowel syndrome (IBS) is a common disorder that affects your large intestine (colon). Irritable bowel syndrome commonly causes cramping, abdominal pain, bloating gas, diarrhea and constipation. Despite these uncomfortable signs and symptoms, IBS doesn't cause permanent damage to your colon.” 

For most students and patients of mine with IBS, it is a chronic condition that they have had since childhood or teenage years that fluctuates from day to day, week to week or month to month. I want to bring special attention that last comment in the quote: IBS does not cause permanent damage to your colon. This in contrast to the less common but more serious GI conditions like Crohn’s disease and other inflammatory bowel diseases that do damage the gut and can have life-threatening consequences. Maybe because IBS does not have such serious consequences, some health care professionals may minimize the impact of IBS. But those who suffer from it know it can be a source of daily discomfort and challenge.

Another aside: since the recent recognition of Celiac disease, gluten allergy and sensitivity and the ability to test for them, many patients previously with an IBS diagnosis have been found to actually be gluten allergic, or have Celiac Disease. This has resulted in a huge improvement in symptoms for these folks as they eliminate gluten-containing foods from their diets. So, if you have been told you have IBS and have not been tested for gluten, do so soon. Also, know that there are newer and more sensitive tests for Gluten allergy, and to learn more, listen to this KPFA broadcast from last week. The discussion is on Lyme disease, but gluten allergy/Celiac testing is also addressed at the start of the program from minute 8 through 22.

It is unclear what the cause of IBS is, but it may have something to do with the smooth muscle lining of the gut walls that helps to move digesting food downstream. In some people the wave of contractions may be too fast or too slow.  It may also be that the neurotransmitter serotonin may play a role in IBS, as a lot of it is found in the gut. The balance of gut bacteria may also be off in IBS. Triggers for IBS are varied and variable from person to person, and include gas or pressure on your intestines, or certain foods, medications or emotions. Hormone fluctuations, especially female ones (IBS is more common in women than men) and stress are also common triggers. The risk factors for IBS include age of onset before 35, being a woman, and having a first degree relative with IBS.

The yoga approach to IBS is similar to some of the posts where we have discussed healthy digestion and eating (see Healthy Eating and Your Digestive System, Meditation and Healthy Eating, and other posts under the label "healthy eating". 

• If you think you may have food triggers, the increased awareness of your body and its reactions to foods you eat that develops with regular yoga practice can help you identify and eliminate your personal food triggers.
• In my practice, I noticed that flares of symptoms are very often related to increased periods of stress in my students’ lives. The effective stress reducing benefits of yoga, either via a well balanced yoga asana practice, or a more focused restorative practice, yoga nidra or simple mindful meditation practices could all help bring your gut into better balance and reduce your symptoms. (See The Relaxation Response and Yoga.)
• For a sluggish gut, with bloating and constipation, try Supta Baddha Konasana (Reclined Cobbler’s pose or Queen’s pose), and for an overactive gut with cramping and tendency for diarrhea, try Viparita Karani (Legs Up the Wall pose). 
• If you have not taken the “tour of your GI tract” we posted a while back, you could use it as a guided meditation while setting yourself up in a supported Savasana (see the Audio Tracks tab at the top of the page to find this audio track). 

And if you want to learn more about Yoga for Healthy Digestion, look for the free interview coming up in the next week or so on YogaU Online, and my more detailed two-night lecture on July 23 and 25th, 8:30-9:30 EST (see here).

CHRONIC STRESS: AN INTRODUCTION

by Nina

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Wounded Bird by Brad Gibson

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by:

• raising your blood pressure
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut)
• dilating your pupils and bronchioles, providing improved vision and oxygenation
• generating needed energy by breaking down sugar and fat stores for immediate use

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract
• contracting your pupils and your bronchioles for reduced oxygenation
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease
• hypertension (high blood pressure)
• insomnia and/or fatigue
• digestive disorders
• headaches
• chronic anxiety or depression
• weakened immune system

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.