Relaxation to Treat IBS and IBD

Millions of people who suffer from irritable bowel syndrome and inflammatory bowel disease might find relief from meditation and relaxation techniques.

Two common gastrointestinal disorders, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), cause discomfort and downright pain for millions of Americans. Although both conditions can be difficult to treat, researchers have found a natural way to help calm symptoms. The key is learning to use your body’s own relaxation response.

IBS is marked by abdominal discomfort and changes in bowel movement patterns that can come and go. While not life-threatening, the pain and bowel urgency can negatively impact your lifestyle.

IBD is typically more serious. It includes conditions caused by chronic or recurring immune responses and painful inflammation of the gastrointestinal tract. The two most common forms of IBD are ulcerative colitis, marked by inflammation of the large intestine, and Crohn's disease, which affects the entire digestive tract.

IBS has no cure, so doctors work with patients to try different diets, medicines, probiotics, and counseling in hopes of soothing symptoms. There are no medical cures for IBD, either, although several prescription medications can help control the disorder. In severe IBD cases, surgery to remove part or all of the colon and rectum is needed to relieve pain and prevent more complications.  

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Stress, anxiety, and depression often increase IBS and IBD symptoms. In fact, stress can trigger or worsen symptoms in both conditions. Then the increased symptoms tend to cause even more stress.

Searching for a way to break this vicious cycle, researchers at Massachusetts General Hospital (MGH) and Beth Israel Deaconess Medical Center conducted a pilot study of IBS and IBD patients who were taught to elicit the relaxation response.

First described almost half a century ago by Herbert Benson, MD, director emeritus of the MGH Benson-Henry Institute, the relaxation response is a natural physiological reaction to several practices such as self-hypnosis and deep breathing exercises. It’s characterized by slower breathing, lower blood pressure, a reduced heart rate, and a feeling of increased calm and well-being, according to the National Center for Complementary and Integrative Health.  

The researchers found that when IBS and IBD sufferers were taught how to elicit the relaxation response, they experienced significant relief of their symptoms in only nine weeks. What’s more, the scientists found practicing the relaxation techniques changed the expression of genes related to inflammation and the body's response to stress.  

"Several studies have found that stress management techniques and other psychological interventions can help patients with IBS, at least in the short term; and while the evidence for IBD is less apparent, some studies have suggested potential benefits,” said researcher Braden Kuo, MD, the director of the Center for Neurointestinal Health at MGH and a neurogastroenterologist (he studies and treats gastrointestinal motility problems that have a mind-gut connection).

“What is novel about our study is the demonstration of the impact of a mind-body intervention on the genes controlling inflammatory factors that are known to play a major role in IBD and possibly in IBS," Kuo explained.

For about two months, the research subjects participated in a group program that focused on stress reduction and healthy lifestyle behaviors. Each weekly session included relaxation response training. The IBS and IBD patients were also asked to practice relaxation response elicitation at home for 15 to 20 minutes daily.

When the study began, as well as halfway through and at the end of the program, the research participants were assessed for pain, anxiety levels, and to see how gastrointestinal symptoms were impacting their quality of life. Blood samples were also taken before the relaxation training began and then a week after the study concluded, to check for evidence of inflammation and profile the expression of genes associated with inflammation.

The results showed that participating in the mind-body program significantly improved disease symptoms, anxiety, and overall quality of life. What’s more, these benefits were still evident three weeks after the study concluded.

Even though lab tests found no major changes in inflammatory markers in the participants, they did reveal beneficial changes in the expression of almost 200 genes in people with IBS and more than 1,000 genes in those with IBD. This is significant because many of these genes with altered expression are known to be linked to stress responses and inflammation.

The researchers also found both IBS and IBD patients were less likely to focus on their pain after the relaxation response training, and they became more resilient when experiencing discomfort.

"Our results suggest exciting possibilities for further developing and implementing this treatment in a wider group of patients with gastrointestinal illness," Kuo said.

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