Case Study: Yoga and Gastrointenstinal Distress

by Baxter

Angry Doe by Marie Lossky (@Marie.Lossky on Instagram)

For over 15 years, I have been seeing clients and yoga students regularly in one-on-one sessions to address many different health issues using yoga’s powerful tools. Today, I’d like to share a short case study that looks at the effect of yoga on gastrointestinal symptoms. 

SB is a 50-year old professional women who initially came to see me for yoga recommendations on how to address her long-standing low back pain, with a secondary concern about her stress levels. Interestingly, she did not mention having any difficulties with her digestive system until we had been working together for several years. In my experience, this is not so unusual, as many people are reluctant to discuss issues related to elimination unless directly asked. So, for the first years of our work together, we focused on designing a home practice that could address her lower back and stress levels, which included a mixture of asana, pranayama, and meditation. She typically did her home practice right after work or before a dance class she was able to re-join as her back pain improved. And although her stress levels improved over time, she continued to note that her work was an ongoing stressor. 

When she asked if we could design a short morning practice that she could do before work at home with her partner, who also had a history of chronic low back pain, I said of course, and immediately created one. And this new addition to her home practice came with an unexpected beneficial side effect! She returned a few weeks after starting her new morning practice to report that to her amazement some annoying gastrointestinal (GI) symptoms had disappeared after a few days of her morning yoga practice. She reported that for years she would have a bout of explosive diarrhea each morning shortly after arriving at work. The addition of her morning yoga had completely resolved this daily inconvenience. In my opinion, it is likely that her GI symptoms were stress-related, and that the morning yoga was addressing that by reducing her stress levels. As she herself said:  

“As an added benefit, [after starting my morning practice] I also immediately reduced morning GI issues related to stress. This wasn’t something I imagined would occur, but it was a welcome secondary benefit. I believe doing the home practice in the morning before work helped regulate my nervous system as well as help stretch and strengthen my body.” 

Although persistent GI symptoms warrant a visit to your doctor to rule out more serious underlying conditions, a good starting place for new, milder symptoms that could be directly related to stress is trying yoga’s stress management tools. For specific recommendations, check out Using Stress Management Techniques for Medical Conditions and  How Yoga Helps Your Digestive System.

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How to Practice If You Have Digestive Problems

by Baxter and Nina

Doctor and Doll by Norman Rockwell*

In general, a balanced practice that includes a well-rounded selection of active poses plus stress management will help keep your digestive system healthy. However, if you are currently having digestive problems or if you’re one of those people who have a sensitive digestive system, you can use the techniques we’re recommending here to improve your digestion.

Before practicing, consider your current condition. If you are presently in good health, we recommend that you practice a well-balanced yoga sequence that includes active poses, (both dynamic and static) and restorative poses or gentle supported inverted poses, along with meditation, breath work, or conscious relaxation. The active poses will provide exercise that is beneficial for your digestive system, supporting good circulation to your digestive organs, strengthening the muscular supports around your digestive organs, and stimulating good elimination. The restorative poses, meditation, breath work, and/or conscious relaxation will allow you to spend more time in the Rest and Digest state, which allows your digestive system to function optimally.

If you’re currently having digestive problems, we recommend that you focus mainly on gentle asana, restorative poses, and conscious relaxation, which will allow you to spend more time in the Rest and Digest state while also reducing overall stress levels that could be contributing to your problems. As you start to return to normal functioning, gradually add in more physical challenges in a step-wise fashion. For standing poses, start with dynamic poses, as they are less demanding than static standing poses, and eventually add in static poses when you’re ready. 

Cautions: Using asana for exercise is not recommended for severe cases of diarrhea or constipation, or if you’re having an acute bout of pain related to your digestive disorder. In these cases, we recommended turning to restorative yoga and stress management. For severe diarrhea in particular, Legs Up the Wall pose with a small support under the hips provides a slight inversion that could slow down diarrhea while shifting you to the Rest and Digest state. For conditions where pressure on your belly is painful, avoid restorative poses, such as supported Child’s pose, that cause abdominal discomfort.

How Often to Practice. If you’re currently having digestive problems, practice five to six days a week, alternating days of gentle asana practice with quiet days of restorative yoga and conscious relaxation. If you’re suffering from chronic stress, however, we recommend including a short stress management session six to seven days a week (see Stress Management below).

What to Practice. We recommend that your sequences include a mix of active asanas and restorative poses, as well conscious relaxation, breath work, or meditation. Depending on the type of digestive problems you have, what you practice for the asana section of your sequence will need to vary quite a bit, as you learn what works for you. However, in general, it’s wise to start with gentler asanas, including gentle reclined and seated poses, chair variations of standing poses, gentle supported inversions, and restorative poses. Gradually add in more challenging poses, including both static and dynamic poses, as you monitor the response of your digestive system to them. 

Static Poses. Focus on static poses that strengthen and stretch your abdominal area to help tone your abdominal muscles that house and support the majority of the organs of digestion, and that can assist in moving material through your system. These include:

• Back-bending poses, such as Warrior 1, Locust, Cobra, Upward-Facing Dog pose and Bridge pose, which all stretch the front of your abdomen and strengthen the back of your torso.
•  Side-bending poses such as Crescent Moon pose, Easy Sitting Side Bend, Triangle pose, and Extended Side Angle pose, which stretch and strengthen the sides of your abdomen.
• Seated and standing forward bends, which apply pressure to your abdominal area, strengthening the front of your abdomen while stretching your back, and may assist in moving material through the system. 
• Seated or reclined twists, which squeeze your abdominal area, stretching your back and strengthening the front of your abdomen, and may assist in moving material through the system.

Dynamic Poses and Flow Sequences. Focus on dynamic poses that fold, stretch and twist your abdominal area to improve blood and lymph circulation, and create a squeeze and release affect on your organs, which may support improved functioning and stimulate good elimination. These include:

• Sun Salutations
• Cat/Cow
• Mountain pose to Arms Overhead pose to Standing Forward bend and back
• Seated twists and side bends done dynamically

Restorative Poses and Conscious Relaxation. We highly recommend practicing restorative poses where your chest is lifted and your belly is very relaxed, such as Reclined Cobbler’s pose, because these may bring you quick relief. In addition, if you have sluggish digestion or elimination, we recommend practicing Child’s pose with a bolster to see if that helps. If you have a condition that is worsened by anxiety or stress, we recommend practicing conscious relaxation in Savasana with support for your chest, and bring your mental focus to your abdomen, simply noticing any sensations that arise. 

Stress Management. One of the most effective ways to influence your digestive system over time is to practice stress management techniques—including meditation, pranayama, restorative yoga, and conscious relaxation—as often as you can manage, every day, if possible. Reducing stress levels improves the functioning of your digestive system. It also helps reduce stress eating. While we can’t say that any of the stress management techniques are better than others, you may find that one or two work best for you. So, if possible, practice all of them periodically to be familiar with all of them. You can practice any of these stress management techniques as a part of your regular asana practice or on their own, at a different time of day. See Stress Management Techniques for When You're Stressed.

Meditation. While meditation is an effective way to spend time in the Rest and Digest state and therefore support your digestive system, a regular meditation practice can also improve your digestion by allowing you through mindfulness to learn about eating habits that may be contributing to your problems and by fostering will power to change them. If you are concerned about using your practice to learn about the effects of various foods on your digestive system, use meditation practices that focus on your physical sensations, such as your breath or even the sensations that are arising in your abdominal area. For improving willpower with meditation as a way of changing unhealthy eating habits, any meditation technique will do. See Yoga Meditation Techniques. 

Sleep. If you are having ongoing sleep problems, focus your practice on improving the quality of your sleep, as it will greatly benefit your digestive system by providing a prolonged rest for your entire system, during which you spend time in the Rest and Digest state. See 5 Tips for Better Sleep for recommendations.

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