Irritable Bowel Syndrome (IBS) does not have a single cause and there is a wide variety of reasons why someone may develop the condition. Therefore, several factors can provoke the symptoms of IBS, one of them being stress.
Stress, anxiety, low mood and poor mental health can all affect how our gut functions, via the gut-brain axis and can play a role in symptom severity in IBS. As stress plays a role in IBS it has been thought that targeting the gut-brain axis can be used to help people with IBS manage their symptoms.
Yoga consists of asanas (body postures) as well as pranayama (proscribed breathing patterns) and meditation, which together have the potential to impact a patient’s physical and psychological health. Yoga is commonly used to reduce stress and pain. It has also been used for people suffering from IBS to help improve their symptoms.
A low-FODMAP is also prescribed to those suffering from IBS. The low-FODMAP diet involves removing certain types of carbohydrates from the diet including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols as it thought that these might be contributing to symptoms of IBS. The low-FODMAP diet can be successful in some individuals however, it needs to be completed carefully alongside a dietician or nutritionist as the diet is very restrictive and can result in nutrition deficiency.
What does the research say?
A group of researchers set out to compare the effectiveness of two treatments for IBS, yoga and the low FODMAP diet.
The yoga group received hatha yoga (a type of yoga practice) for 75 minutes two times a week, for 12 weeks. The sessions had been designed specifically for those with digestive issues. As well as the classes the group also received a written manual and three half-hour videos so they were able to practice the yoga at home. It was encouraged they participate yoga every day.
The low-FODMAP group received four 60-90 minutes of nutrition counselling sessions for 12 weeks. This included two group lessons and two private sessions, each person was given a nutritionist to guide them. The group also received resources including a pamphlet with instructions on how to eat a low-FODMAP diet, some easy low-FODMAP recipes and a list of foods which are not low-FODMAP and what to replace them with.
Before and after the study the researchers monitored the participants using the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS). The IBS-SSS measures five symptoms of IBS:
Individuals rated each of these items out of 100, with higher numbers representing more severe gastrointestinal symptoms related to IBS, with 500 being the maximum score. Participants who score 75 are considered to be in remission if their previous score was higher. A decrease in a participant score of 50+ points indicates a clinically relevant improvement in their IBS.
At the start of the study, the participants in the yoga group had an average score of 263.02 on the IBS-SSS, by week 12 their score had dropped to 196.86. In the low-FODMAP group, the average IBS-SSS score at the start of the trial was 259.73 and dropped to 163.55. Whilst the low-FODMAP score was lower, the difference between the score at week 12 between the yoga group and low-FODMAP group were not significantly different.
This study demonstrates that both yoga and a low-FODMAP diet are effective in reducing the symptoms for people suffering from IBS. However, both must be carried out correctly to avoid injuries and nutritional deficiency alongside an appropriate health care professional.
Schumann, D., Langhorst, J., Dobos, G. and Cramer, H., 2017. Randomised clinical trial: yoga vs a low-FODMAP diet in patients with irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 47(2), pp.203-211.