Can Yoga Help Heal Digestive Disorders?

Elyse R. Thakur, PhD

Credit: Atrium Health

A systematic review evaluated the effectiveness of yoga as a treatment for gastrointestinal (GI) disorders, with results demonstrating that yoga improved symptoms such as mood, sleep, stress and quality of life across these conditions.

Stress has been shown to contribute to the development of and/or exacerbate GI symptoms. Unfortunately, many conventional pharmacologic and dietary treatments don’t focus on the psychosocial or environmental factors that are involved in the stress response. Although data has supported behavioral therapies for the management of disorders related to the gut-brain interaction, access is limited due to the lack of psychologists trained in psychogastroenterology. Therefore, many patients lean on complementary and/or integrative approaches, such as yoga, to alleviate their symptoms.

“Yoga may benefit multiple organ systems, including the GI tract,” wrote a team of investigators led by Elyse R. Thakur, PhD, clinical health psychologist and director of clinical psychology at Atrium Health Gastroenterology and Hepatology. “The exact mechanism by which yoga relieves global symptoms in irritable bowel syndrome (IBS) is unknown but may involve modulation of the brain-gut axis via stress reduction, increased stimulation of the vagus nerve, or direct mechanical alterations of the gut.”

Investigators used PubMed and Embase databases to identify studies that evaluated yoga as a treatment for GI conditions among patients aged 18 years and older. Eligible trials required a diagnosis of any GI disease based on either specific diagnostic criteria or a clinician’s assessment.

Out of 1,275 articles, 12 studies were reviewed, covering conditions including IBS (7 studies), ulcerative colitis (1 study), chronic pancreatitis (1 study) and gastrointestinal cancer (3 studies). Although the design and methodology were heterogenous among studies, most were randomized controlled trials (RCTs) and most compared yoga with a control group. Among the 615 participants, most were female (73.3%) and although adults of all ages were included, most were in the middle adulthood range.

Exposure to the intervention ranged from 1.5 to 53 hours over a 6 to 12-week period, along with a follow-up period of between 0 and 6 months. Despite the heterogeneity, the risk of bias was generally low.

In one study evaluating IBS, the IBS Symptom Severity Scale (IBS-SSS) was significantly improved among patients in the yoga group compared with controls, as well as the combination group compared with controls at weeks 6 and 12. A follow-up study revealed sustained improvements in symptoms and quality of life in the yoga cohort. For patients with inflammatory bowel disease (IBD), quality of life measurements showed significant improvements in the yoga group compared with patients who received self-care at weeks 12 and 24.

In the one study assessing the impact of yoga on chronic pancreatitis, patients receiving the intervention had significant improvements in quality of life compared with controls, as well as improvements in stress, mood changes, alcohol dependence and appetite.

Among those with gastrointestinal cancer, investigators did not see any significant differences in terms of health-related quality of life, which was attributed to low adherence, with only 50% of patients attending the yoga sessions. However, patients in the yoga group saw improvements in emotional well-being, had less sleep disturbance and reported statistically significant improvements in anxiety and depression symptoms.

Seven studies evaluated potential adverse events, which showed the number of serious adverse events were minimal and unrelated to the yoga interventions. Common non-serious adverse events included musculoskeletal pain, such as generalized muscle soreness, neck pain, abdominal pain, hip pain and low back pain.

“Yoga has the potential to improve functioning across a broad spectrum of gastrointestinal diseases, and as a safe and non-invasive treatment option that can likely be a useful complement to usual medical care,” investigators concluded. “Future research is needed to evaluate the impact of yoga on health outcomes for a broader range of gastrointestinal diseases, as compared with other available treatment options.”