Befriending the Belly
At best an IBS episode can be uncomfortable; at worst it’s debilitating and embarrassing. Thankfully, yoga offers some simple solutions.
By Kelly McGonigal
When something doesn’t feel right in your gut, it’s usually a sign that something isn’t right in your life. Gut feelings can be a message from txhe brain as much as from the belly. If you are one of the many people who suffer from irritable bowel syndrome (IBS), this message manifests as more than an occasional discomfort. It is a chronic experience of abdominal pain and digestive distress that reflects the intimate link between the mind and the body. But take heart—yoga can relieve your symptoms by reducing stress and teaching you how to listen to your body.
IBS has the unusual distinction of being both one of the most common health conditions—affecting as many as 45 million people in the United States—and the condition you’re least likely to talk about. Who wants to describe the cycles of bloating, gas, constipation, and diarrhea? Or admit to feeling at the mercy of an unpredictable and uncooperative digestive tract? IBS has also long been a bit of a medical mystery. The symptoms suggest a problem in the digestive tract, but people with IBS show no physical damage to their stomach, intestines, or colon.
Instead, the problem seems to lie in how the nervous system communicates with the digestive tract. Your brain and gut are intricately linked—you might even say that the gut is where the mind and the body meet. Your digestive tract contains hundreds of millions of nerve cells that receive a constant barrage of signals about the state of your body, thoughts, and emotions. This makes your gut highly responsive to changes in your well-being, both physical and emotional.
Some experts believe IBS is caused by a disruption of normal brain–gut interactions. For people with IBS, the nerves of the digestive system become oversensitive. The digestive tract overreacts to food, stress, and other demands on your body and mind. Along with these digestive symptoms, people with IBS tend to suffer from high levels of anxiety. It is currently unknown whether the chronic digestive problems create chronic anxiety, or whether heightened levels of stress and worry trigger heightened gut sensitivity. But findings linking the gut and the brain help chart a clearer path to healing. To gain freedom from IBS, you need to reduce stress, get comfortable with discomfort, discover your symptom triggers, and restore normal function of the digestive tract.
Yoga can be an important part of each step. Two clinical studies—one by researchers at the All India Institute of Medical Sciences in New Delhi in 2004, and the other by researchers at the University of British Columbia in 2006—have shown that daily practice of basic yoga postures with mindful breathing can reduce both the emotional and the physical symptoms of IBS. You can create your own healing yoga practice by following a few simple guidelines and trying the following sequence of postures.
How Yoga Can Help
Stress is one of the most common triggers of IBS symptoms. Yoga can help you shut down stress by calming the nervous system—and, in the process, calm your irritated digestive system. For the best results, choose postures that are accessible, not overly ambitious. You don’t want to struggle to squeeze your body into postures that are more painful than peaceful. Make steady, smooth breathing the focus of your practice; if your breathing is strained, it will reinforce your stress and symptoms. Finally, be sure to include a relaxation pose at the end of your practice, and even consider starting your practice with relaxation. This can send a clear signal to your body and mind that it is time to slow down, let go, and shift toward a healing state.
Yoga can also help you tolerate uncomfortable sensations. If you have IBS, you have probably learned to recognize the first signs of an episode. You may be vigilant for any change in sensation in your belly and gut—the pressure of bloating or the first twinge of cramping that warns you things might quickly get worse. Unfortunately, anxiety about gut feelings can actually intensify your symptoms. But if you breathe and stay with the sensation, your body learns to relax, even with intense feelings. You can learn to be with your symptoms in the same accepting mindful way that you stay with the sensations of a yoga pose. This can profoundly change your experience of the pain and keep a mild episode from becoming severe.
Yoga can even help you prevent episodes altogether by making you aware of what makes your symptoms worse. From specific foods to caffeine, alcohol, or sleep deprivation, every IBS sufferer has triggers they can learn to avoid. Yoga is a perfect training ground for cultivating a heightened awareness of cause and effect in your body that carries over to choices off the yoga mat. With time, you will find yourself having stronger insights into what is healing, and what is harmful, to your body. You will find yourself wanting to do what is good for your body, and less attracted to what makes your symptoms worse.
Finally, yoga may help restore normal motility of the gut. When you have IBS, the contractions of your intestines may be slowed to the point of constipation or spasming to the point of diarrhea. Some yoga poses, like seated twists or prone backbends, put gentle pressure on the abdominal organs. Others, like side bends and reclining twists, release tension around the abdomen. A well-sequenced yoga practice will send gentle pulses of compression and stretch to sensory receptors along the digestive tract. This combination of pressure and release is believed to help balance the contractions of the gut, whether getting things moving or slowing things down.
The following sequence will help re-duce stress, release tension in the abdomen, and support general digestive health. It can ease discomfort during your milder symptoms and help prevent future episodes.
You can practice this sequence on its own or following a series of warm-ups and standing poses. As you hold each posture, stay with the sensations of your body and breath. Use the least amount of effort needed to hold the postures with integrity. Remind yourself in each pose to release any unnecessary tension throughout the body.
Parighasana (gate pose)
From tall kneeling, stretch your right leg out to the right, heel on the ground, foot flat, toes reaching to the floor. Inhale and lift your left arm up; exhale and lean your torso over the right leg. Rest your right hand on a block, the floor, or your shin. Reach through the left arm and hand with clear intention, noticing how this gesture increases the stretch in the left side of your body. Feel the breath in the left rib cage, waist, and belly. Choose a position for the head and neck that feels least strained, and remember to relax your face, softening your forehead, eyes, mouth, and jaw.
Stay in the pose for 5 to 10 breaths, then repeat on the other side. After practicing this posture on both sides, return to kneeling. Place your hands on your side ribs, and feel the movement of the breath under your hands. Inhale and exhale patiently and fully, letting your rib cage expand and contract.
Ardha matsyendrasana (half-seated spinal twist)
Come into a seated position, extend your left leg and cross your right leg on top, planting the foot flat on the ground next to your left knee. Then bend your left knee and bring the left foot to the outside of the right hip. Sit evenly on both hips and lengthen up through your spine. Slowly turn your torso toward the right leg. You can hug the right knee with your left arm, or bring the left elbow across the right thigh and press the outer thigh into the upper arm. As you exhale, slowly draw your navel toward your spine to help press the breath out smoothly. You may find that you can twist a bit more with each exhalation, but do not force or strain.
If this twist feels too compressive, try twisting in the opposite direction—to your left, away from the top leg. This version of the pose gives a little more space for the abdomen to relax and for the belly to breathe.
Hold for 5 to 10 breaths, then switch sides.
Jathara parivritti (reclining abdominal twist)
Lie down on your back with both legs straight. As you exhale, bend your right leg and hug it in to your belly. Pause here for a couple of breaths. Then take the right leg across your body, rolling to your outer left thigh and hip. Reach your right arm back, extending straight out from the shoulder, palm up. Let your right shoulder blade come off the ground, so that the spiral of the posture moves all the way from your legs through your pelvis, spine, ribs, and chest. If the pose feels too intense, consider placing a blanket or other support underneath the right knee and/or right arm. As you rest in the pose, feel the breath stretching the lower belly, side waist, and chest from the inside out.
Hold for 5 to 10 breaths, then return to lying on your back. Repeat on your
Salamba setu bandhasana (supported bridge pose)
Place a bolster, a stack of firm blankets, or a block underneath your hips and lie on your back. Make sure the support is under your sacrum and pelvis, not your lower back or ribs. Slide your legs out straight, and relax your arms by your side, palms up. If you have a strap, loop it around the mid-thighs to support your legs in place. The strap should be tight enough for you to completely relax the effort in your legs, but not so tight that the legs are squeezed together. If you don’t have a strap, you can place the soles of your feet against a wall to provide more support for your legs.
Stay in this posture for at least 10 breaths, and up to five minutes. As you hold the posture, bring your awareness to your belly. Imagine that you are inhaling and exhaling through your navel, the breath moving into and through any tension in your abdominal organs. Sense the tension dissolving with each breath. When you come out of the posture, rest for 5 to 10 breaths lying on your back, hands on your belly.
If this posture is not comfortable, or you do not have props available, consider another gentle inversion, viparita karani (legs-up-the-wall pose).
Ananda balasana (happy baby pose)
Lie on your back, hug your knees into your chest, and take a breath or two, feeling your back relax into the support of the ground. Then let your knees drop wide apart, and reach the soles of your feet toward the ceiling. Keep your legs bent, with your feet directly over your knees. Hold on to the big toes or the sides of your feet. Relax into the pose, without trying to pull yourself deeper into it. Let the arms be straight, shoulder blades dropping to the ground. Relax the weight of your hips, lower back, and ribs, and feel the stretch in your groin and hips. Let the movement of your breath and belly fill the open space between your legs. Stay here for 10 breaths.
If this posture is too intense a stretch for your hips, practice supta baddha konasana (reclining bound angle pose) instead.
After you complete this sequence, rest in shavasana (corpse pose). Practice slow abdominal breathing, allowing the belly to rise and expand as you breathe in, and sink as you breathe out. Place your hands on your lower belly. Let this gesture be a comfort, reminding you of your deep desire to take care of yourself. If you have any discomfort in your abdomen, imagine the breath moving into and through the pain. Let the breath lead you into a state of deep rest and healing.
Kelly McGonigalis the editor in chief of the International Journal of Yoga Therapy and the author of Yoga for Pain Relief (New Harbinger 2009).
Read Ayurvedic advice on IBS.
Photos by Andrea Killam; Model: Shawn Laster; Wardrobe: by Prana