Yoga in Patients With Inflammatory Bowel Disease: A Narrative Review

Abstract

Despite advancements in the treatment of inflammatory bowel disease (IBD), the global prevalence of IBD is increasing. Patients with IBD often experience a high psychosocial burden, worsening their IBD symptoms and increasing relapse, hospitalization rates, and healthcare costs, which impairs their quality of life (QoL). Evidence suggests that mind-body intervention in many chronic illnesses is effective in improving symptoms and QoL. Yoga is the most frequently used mind-body practice globally. Meta-analyses of randomized clinical trials and prospective studies have highlighted that yoga improves symptoms and QoL of patients with IBD; however, recommendations about indications for yoga as well as dose and frequency of yoga are lacking. The present narrative review aims to describe the available evidence regarding the effects of yoga on common patient-reported outcome measures in IBD, including depression, anxiety, stress, and QoL. Physicians can hence promote yoga interventions in their discussions with patients to help control these IBD-related outcome measures.

Keywords: anxiety; depression; inflammatory bowel disease; quality of life; yoga.

Figure 1.

Effect of yoga practice on central nervous system structure and function. The central mechanisms of action for the therapeutic effects of yoga involve changes in grey matter morphology, enhanced cerebral blood flow, and cerebral activity, resulting in altered neurotransmitter (GABA, BDNF) expression. The mechanism involves increasing grey matter density in yoga practitioners with its effects observed in the hippocampus and amygdala. The effects of hippocampal are linked to increased BDNF levels, a marker for neuroplasticity, whereas a decline in amygdala volume is associated with decreased perceived stress among yoga practitioners. Yoga shows its effects on cerebral blood, with many studies demonstrating increased neural activation in the pre-frontal cortex during yoga practice. Following yoga practice, an increase in GABA levels can be observed associated with decreased stress and may be a consequence of pre-frontal cortex activation.