Living with ulcerative colitis (UC) can be extremely stressful. Dealing with the flare-ups and day-to-day fatigue that come with the autoimmune disease can zap your energy and leave you feeling exhausted.
Research shows that yoga, a mind-body technique that incorporates physical postures, breath control, and meditation to promote health and relaxation, may help reduce stress, anxiety, and pain. It may also improve quality of life for people with an inflammatory bowel disease (IBD) like ulcerative colitis.
A study published in June 2017 in the journal Alimentary Pharmacology and Therapeutics looked at the impact of yoga on those living with UC. Of the 77 patients studied, those who were assigned to 12 supervised 90-minute weekly yoga sessions had a greater increase in quality of life and reduced activity of their colitis compared with those who were given written self-care advice.
“We found that yoga can increase quality of life in patients with ulcerative colitis more effectively than simple self-care advice,” says lead author Holger Cramer, PhD, associate professor on the faculty of medicine at the University of Duisburg-Essen in Germany. “Practicing yoga also reduced stress, anxiety, and depression. In the longer term, disease activity was reduced in those who had used yoga compared with the control group.”
Cramer notes that patients in the study were in remission but still suffering from impaired quality of life. “So yoga can be considered a safe and effective adjunct treatment for this patient group, to improve quality of life and mental health and perhaps even reduce the risk of flare-ups,” he says.
Ann Ming Yeh, MD, clinical assistant professor of pediatric gastroenterology at Stanford University in San Francisco, studies the use of mind-body interventions, including yoga, on children living with inflammatory bowel disease. In a review published in April 2017 in the journal Children, she and her colleagues found that there have been no good studies evaluating yoga as a potentially effective complementary therapy for children with IBD.
Still, Dr. Yeh says there is reason to believe that yoga could be beneficial to patients with the disease, including kids.
For example, in the review she and her colleagues found several studies showing that yoga significantly improved gastrointestinal symptoms and quality of life for pediatric and adolescent patients with irritable bowel syndrome (IBS).
“A lot of patients who have IBD have IBS overlay,” Yeh says. “And we know that yoga works for IBS.”
Yeh says more research is needed in the area. She and her team are currently working on a pilot study looking at whether yoga would be an effective adjunct therapy for children with IBD.
Starting a Yoga Practice
There are many types of yoga, and certain styles may not be right for people with ulcerative colitis.
Yeh says if you’re experiencing any IBD-related symptoms, it’s best to stay away from more active forms of yoga, including Vinyasa and power yoga. And since many people with diarrhea also experience dehydration, you should avoid all forms of hot yoga.
“I tell my patients, if you’re in remission then that [hot yoga] might be fine, but if you’re experiencing any type of disease activity then you need to get everything under control first,” she says.
The safest bet, especially for beginners, according to Yeh, is Hatha yoga, a relatively gentle form of yoga that incorporates physical postures and breathing exercises. Poses include lunges and forward and backward bends, as well as traditional, perhaps more recognizable yoga poses, like “warrior” and “tree pose.”
She and her team also found that Iyengar yoga, a specific form of Hatha, which emphasizes movement and alignment, may benefit people with gastrointestinal issues, but more research is needed. In Iyengar yoga, poses are held for long periods and props, including belts, blocks, and blankets, are often implemented throughout class. These props can help students perform the poses correctly and minimize the risk of injury.
If you have ulcerative colitis and want to try yoga, Yeh recommends speaking with your doctor.
“I think it’s always good to get some clearance, especially if you’re severely ill or have any kind of joint disease associated with IBD,” she says. “If you’re in remission, starting with a low Hatha practice would be a good idea.”