In addition to my role with the GI Society, I’m a registered yoga teacher. I’ve witnessed many nervous expressions on the faces of participants attending their first yoga class. This is understandable, considering the popularized image of yoga in North America is young, fit people, bent in uncomfortable looking positions. I reassure my students that not everyone can do every pose but everyone can do yoga. Yoga does not discriminate against age, size, race, ethnicity, mobility level, or disease state. Each individual’s yoga practice may have limitations because of personal circumstance, but there is almost always the ability to quiet the mind, take a nourishing breath, and move the body gently to create openness and release tension. Developed in ancient India, this Hindu discipline unites the principles of breathing, meditation, and postures to bring both physiological and psychological benefits to the participant.
Breathing Patterns (pranayama)
In the Inside Tract®, issue 185, in the article “Healthy Breathing for the Mind, Body, and Gut,” we discussed disordered breathing, which often takes the form of rapid upper chest breathing. During a yoga practice, we consciously deepen the breath, taking long inhales and exhales through the nose. Breathing is the only autonomic function in the body that we can also control voluntarily.1 Slow, mindful breaths increase parasympathetic nervous system tone, which is responsible for the ‘rest and digest’ functions in the body.
In a small study,2 a group of 12 healthy participants who were novices to yoga underwent 30 days of yoga training. Researchers compared them to a similar group who did not receive any training. After the intervention period, the yoga group showed a significant decrease in both their baseline heart rate and the lowest heart rate achieved voluntarily over a six-minute period. In contrast, the non-yoga group showed no change from their baseline assessment.
Focusing on our breath also helps to quiet down the mind, allowing us to be more aware of what’s happening in our body and not drift off with thoughts of future obligations or experiences. The philosopher William Penn eloquently explains, “True silence is the rest of the mind, and is to the spirit what sleep is to the body, nourishment and refreshment.” The brain-gut connection is very strong. Negative thoughts or heightened emotions can cause the body to be in a tense, anxious state, which may exasperate digestive symptoms.
Physical Postures (asanas)
The physical yoga postures build strength and flexibility, help with balance, and can increase range of motion in the body. There are both standing and seated postures and almost every pose has modifications to accommodate different body types. The various asanas massage the internal organs, resulting in enhanced blood circulation, improved glandular functioning, and balancing of hormone production.3
More and more Canadians are practicing yoga, not only for stress relief and exercise, but also as a means of helping to manage chronic conditions. Research shows yoga can reduce pain and disability and increase quality of life for various conditions in adults, including migraines, rheumatoid arthritis, osteoarthritis, and chronic low back pain.3 However, the scientific studies are not as plentiful or as thorough when it comes to yoga’s usefulness in alleviating digestive disease symptoms.
A small study compared yoga versus conventional treatment in males 20-50 years of age who had diarrhea-predominant irritable bowel syndrome (IBS-D).4 The 9 participants in the yoga group practiced a set of 12 yoga postures and one breathing exercise twice a day for two months. The 12 subjects in the conventional group received symptomatic treatment with loperamide 2-6mg/day. Both the medication and yoga groups improved equally on decreasing bowel movements and anxiety. The yogic intervention showed significantly enhanced parasympathetic reactivity at the end of the second month, indicating a decrease in stress response.
A case control study compared 186 patients with chronic diseases (including gastrointestinal) who regularly practiced yoga with 186 matched controls who did not.5 Patients who practiced yoga reported better overall health status and physical quality of life than those who did not. The study’s authors hypothesize yoga may improve the health of these patients by relieving pain and muscle spasms through the physical postures, increasing awareness of muscle tone and joint position, and changing habitual patterns of posture and muscle tension.
It’s Your Practice
Although we need more research to determine how yoga fares as a complementary treatment for gastrointestinal diseases and disorders, when practiced safely, it’s an effective way to reduce stress and enjoy physical activity. It’s important to speak with your health care team before trying any new activity.
There are many different styles and schools of yoga that have developed since its origins many years ago. A good first class to try is Hatha yoga because of its slower pace and use of basic postures. There are also gentle yoga classes, which are especially helpful for anyone with mobility issues or a chronic condition. Try to find a studio and teacher that make you comfortable, and make sure you discuss any concerns or limitations you have with the instructor before your first class, so she or he can properly assist you. Most importantly, listen to your body, accept your limitations, and appreciate all your capabilities!
Standing Forward Bend (Uttanasana)
Stand with your feet hip distance apart and your knees slightly bent. On an exhale, bend forward from your hips to come into a forward fold. Let the back of your neck be long and your head be heavy. Allow your arms to hang down or grab opposite elbows.
Cow (Bitilasana) and Cat (Marjaryasana) Poses
Start in a table top position with your hands directly underneath your shoulders and your knees underneath your hips. As you inhale, lift your sitting bones and chest toward the sky. With control, allow your belly to come down toward the floor. As you exhale, round your spine upward, releasing your head toward the floor. Practice these poses separately or together, matching your breath to your movement.
Modifications: You can put padding under your knees for added comfort. If there is pain in your wrists, try doing a fist position instead of having your hands flat on the floor. These poses can also be done while seated in a chair with your hands resting on your knees.
Cobra Pose (Bhujangasana)
Lie face down on the floor with your legs stretched out behind you and the tops of your feet on the floor. Place your hands on the floor underneath your shoulders. Hug your elbows into your body. Press your feet, legs, and pelvis into the floor. On an inhale, press into your hands so your chest lifts off the floor. Only lift to a height that is comfortable for you. If there is any pain in your lower back, come down a little. Soften your jaw. Continue to breathe. Hold for 15-30 seconds and then release down with an exhale.
While in a seated position, use your inhale to grow tall in your spine, lengthening the sides of your waist. On the exhale, begin to twist toward the right. Place your left hand on the side of your right knee, using it as a leverage point to gently deepen the twist. If comfortable for your neck, look back over your right shoulder. Hold for a few breaths; imagine your spine getting taller with each inhale and the twist getting slightly deeper with the exhales. Use an exhale to return to face forward and repeat on the other side.
Modifications: This pose can be done while seated in a chair or in a cross legged position on the floor.
Child’s Pose (Balasana)
Kneel on the floor. Separate your knees about as wide as your hips. Sit back on your heels. With an exhale, release your torso to rest on the tops of your thighs and your forehead to rest on the floor. Your arms can reach out in front with your palms facing down or you can bring them alongside your torso with your palms facing up. Feel how the weight of your shoulders pulls your shoulder blades wide across your back. Take deep breaths into your lower back.
Modifications: If it’s uncomfortable sitting on your heels, try placing a folded blanket or pillow between your heels and your bum. If your forehead doesn’t quite touch the ground, place down a book or two so your head has support.
Warrior II Pose (Virabhadrasana II)
Standing tall, take a big step back with your right foot. Turn your right foot out to the right 90 degrees (your left foot remains pointed forward). Bend into your front leg so your thigh approaches parallel with the floor. Check to see that your right knee is in line with your ankle. Your back leg remains straight but your knee should not be locked. Raise your arms up to shoulder height and reach them actively out to the sides with your palms down. Keep your shoulders directly over your hips. Hold for 15-30 seconds. Repeat on the opposite side.
Modifications: If you have trouble with balance, hold on to the back of a chair instead of reaching out your arms.