“Stress upsets my stomach” and “I was scared spitless” – everyone knows these idioms, but very few of us are aware of the medical connections behind them. Our digestive system is sensitive to psychological stress because the gut and brain are in close communication via the so-called gut-brain axis. This is completely normal and part of physiological reflexes. Emotional tension in particular can alter bowel movements and functions, disrupt blood flow, and increase sensitivity to pain. For this reason, relaxation techniques play a central role in the treatment of functional gastrointestinal complaints, or more precisely, disorders of gut-brain interaction (DGBI), as these conditions are known today. The most common of these DGBIs are functional dyspepsia, affecting approx. 8% of the population, and irritable bowel syndrome (IBS), affecting approx. 12% of the population.
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder. People with IBS suffer from chronic abdominal pain, bloating, and altered bowel habits, without any identifiable organic cause. It is a classic functional disorder. The symptoms are caused by impaired gut-brain communication and are often influenced by stress, diet, or hormonal factors. There are four subtypes: IBS-D (diarrhea-predominant), IBS-C (constipation-predominant), IBS-M (mixed), and IBS-U (unspecified). This categorization into subtypes is important because both diagnosis and treatment are guided by the specific subtype.
The treatment of irritable bowel syndrome is summarized in the German clinical guidelines, follows a multifactorial approach, and includes both basic and specialized measures. The goal of therapy is to alleviate symptoms and improve quality of life. Basic measures include patient education about the condition, dietary adjustments (e.g., low-FODMAP diet), exercise, and stress reduction through mind-body techniques. Specialized measures include the use of medication and cognitive behavioral therapy, which is part of the standard repertoire for disorders of gut-brain interaction. Medications are used according to the subtype, such as antispasmodics, probiotics, laxatives, or antidiarrheals.
Mind-body practices regulate and strengthen the connection between the body and the mind, with the aim of reducing stress, alleviating gastrointestinal complaints, and promoting self-reliant self-regulation. Mind-body practices act through the nervous system, particularly the gut-brain axis, to have a calming effect on the body and can alleviate physical and mental distress. Mind-body practices include a wide variety of relaxation techniques such as progressive muscle relaxation, autogenic training, and meditation, hypnotherapy such as gut-directed hypnotherapy, mindfulness exercises, and medical yoga. The effectiveness of these measures has been proven in clinical studies, particularly for disorders of gut-brain interaction such as irritable bowel syndrome. For this reason, mind-body measures are specifically identified in clinical guidelines for the treatment of irritable bowel syndrome as essential therapeutic components.
IBS yoga describes specific yoga flows, which are tailored to the needs of IBS patients. For this purpose, different yoga flows have been tested in clinical studies for various key symptoms and can be found in manuals on IBS yoga. Yoga therapy includes gentle movements, targeted breathing exercises and relaxation techniques that positively influence intestinal motility and dampen the stress response. In the clinical treatment guidelines, the positive effects on symptom severity, quality of life, and psychological comorbidities are discussed. IBS yoga is recommended as a holistic therapeutic component for all patients with functional gastrointestinal complaints. The safety of yoga is considered to be high; no relevant side effects have been described.
Authors: Prof. Dr. Martin Storr and Angelika Bissinger
published by Trias Verlag, ISBN 9783432109367
In this guide, the authors explain the background of yoga therapy for irritable bowel syndrome and provide precise instructions for individual exercises and effective yoga flows.
Facharzt für Innere Medizin, Schwerpunkt Gastroenterologie
