Irritable bowel syndrome (IBS) is considered a disorder of the gut-brain axis. The gut-brain axis is the two-way communication between our gut and brain and is the reason why in times of stress or anxiety we can experience butterflies in our stomach.
People with IBS have a dysregulation in this interaction, which can cause visceral hypersensitivity. Therefore, it has been suggested that interventions that target this axis, like yoga, can help manage people's IBS symptoms. We have reviewed various lifestyle changes and interventions that can be used for IBS management.
Practising yoga is a method that has been shown to help managed yoga symptoms. A trial carried out by Schumann et al. compared the treatment of a low FODMAP diet and yoga for 12 weeks in 59 IBS patients.
Both groups experienced a reduction in the IBS Symptom Severity Score (IBS-SSS) after 12 weeks of intervention and this effect was sustained for both groups. Additionally, there was no significant difference in IBS improvement between the two groups, suggesting that both the low FODMAP diet and regular yoga practice are effective for IBS symptom management.
Interested in trying yoga? We worked with yoga instructor Antonia Collyns who created a 15 minute stress and anxiety release yoga flow. You can watch it here.
A study carried out by Johannesson et al. assessed the long-term effect of physical activity on IBS symptoms, quality of life, fatigue, depression and anxiety. 39 patients took part in the study and were monitored for an average of 5.2 years. Their frequency of their exercise as well as an improvement in their IBS symptoms, quality of life, fatigue, depression and anxiety were measured.
IBS symptoms had improved compared to the start of the trial, as well as psychological symptoms such as disease-specific quality of life, fatigue, depression and anxiety. The reported time of physical activity during the week had increased from 3.2 hours at the start of the trial to 5.2 hours at follow up. The most common exercises were walking, aerobics and cycling.
The study showed that increasing physical activity has a positive long-term effect on IBS symptoms and psychological symptoms.
A randomised control trial carried out by the same author has also shown that moderately increased physical activity for 12 weeks was able to improve IBS symptoms as well as some aspects of disease-specific quality of life. However, there were no improvements in fatigue, depression or anxiety. Suggesting that the intervention requires a sustained increase in physical activity for broader benefits.
Gut-directed hypnotherapy has been shown in several trials to improve patients' IBS symptoms by providing better coping strategies for psychological problems. It has been recommended by NICE in patients who have not responded to dietary and pharmacological treatments.
A randomised trial carried out by Peters S.L. et al. showed that the efficiency of hypnotherapy was similarly effective to a low FODMAP diet with a positive response in GI (pain, bloating, wind, stool consistency and nausea) and psychological symptoms (anxiety and depression) after six weeks in 71 patients. This effect was maintained after 6 months for both groups.
Dietary changes will not be effective for all patients with IBS however, the above articles demonstrate that there are methods outside of diet that can be effective.
If you would like to book a free 1:1 consultation with our inhouse nutrition team to discuss your gut health, simply click here.
Peters, S.L.; Yao, C.K.; Philpott, H.; Yelland, G.W.; Muir, J.G.; Gibson, P.R. Randomised clinical trial: The efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment. Pharmacol. Ther. 2016, 44, 447–459.
Schumann, D.; Langhorst, J.; Dobos, G.; Cramer, H. Randomised clinical trial: Yoga vs. a low-FODMAP diet in patients with irritable bowel syndrome. Aliment. Pharmacol. Ther. 2018, 47, 203–211.
Johannesson, E., 2015. Intervention to increase physical activity in irritable bowel syndrome shows long-term positive effects. World Journal of Gastroenterology, 21(2), p.600.
Johannesson E, Simrén M, Strid H, Bajor A, Sadik R. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol 2011; 106: 915-922 [PMID: 21206488 DOI: 10.1038