The Relaxation Response for IBS and IBD

Joanne Van Zuidam

Reviewed by QualityHealth's Medical Advisory Board

Irritable bowel syndrome (IBS), a common gastrointestinal problem, affects between 25 and 45 million people in the United States, according to the National Institutes of Health. And 1.6 million Americans are living with inflammatory bowel disease (IBD), in which inflammation in the gastrointestinal tract hinders its ability to function properly. IBS and IBD patients often experience similar symptoms, including abdominal pain and changes in bowel habits such as diarrhea or constipation. There is no cure for either condition, only ways to treat symptoms, like stress reduction techniques, medication, and for some IBD patients, surgery.

Effective stress reduction techniques elicit the relaxation response, a state of deep rest that changes a person’s physical and emotional responses to stress. Now a new study has found that eliciting the relaxation response can actually suppress the activity of genes that produce inflammation in IBS and IBD.

The small study, the first of its kind, was conducted by researchers at Boston’s Massachusetts General Hospital and Beth Israel Deaconess Medical Center, and was published in the journal PLOS One.

IBS, IBD, Stress, and Genes

Researchers recruited 19 people with IBS and 29 people with IBD for a 9-week program. Prior to the start of the study, participants’ symptoms (as well as their levels of pain and anxiety) were assessed, and investigators took blood samples to look for markers of inflammation.

Subjects were taught relaxation techniques including yoga, breath focus (a meditation practice in which you pay attention to your inhalations and exhalations), single-pointed focus (in which you focus on an object, like a candle), imagery, and mindfulness training to stimulate the parasympathetic nervous system, the part of the nervous system that prompts relaxation. The group also learned brain-boosting skills and practiced optimistic thinking.

After the nine weeks, and at a three-week follow up, patients’ symptoms had improved significantly in multiple areas.

Since IBS and IBD symptoms appear to be triggered by stress, confirming that symptoms subside with regular practice of stress reduction techniques shouldn't be a surprise. What is news is the discovery that the relaxation response actually reduced the activity of gene processes involved in inflammation: 1,059 gene processes were affected in the IBD patients, and 119 in the IBS patients. (The big difference in the number of genes affected is due to the fact that inflammation is characteristic of IBD, but not IBS.)

Since there was no control group in this study, further research involving a larger amount of participants and a control group is needed. Braden Kuo, MD, gastroenterologist at Massachusetts General Hospital, and a co-author of the study says there are plans to investigate further, but in the meantime the techniques could offer additional help in improving symptoms. "It’s not a cure," says Kuo, "but it makes an impact on the disease without the use of medications, or with less need for medications."

How to Induce the Relaxation Response

The state of relaxation is described as a calm, peaceful state. For instance, if you’ve ever taken a yoga class it’s the deep relaxation you achieve (or try to achieve) while lying in corpse pose at the end of the class. But you don't have to unroll a yoga mat to prompt the relaxation response. You just need a few minutes to sit and breath deeply. Here’s how:

Sit in a comfortable position.
Close your eyes.
Consciously begin to relax all muscles; start at your feet, then continue upwards relaxing your calves, thighs, abdomen, shoulders, etc., all the way up to the top of your head.
Begin to breathe through your nose.
Silently repeat a mantra after each exhale. A simple word like, “one” or “om” will keep you focused on the breath.
Continue for as long as you can, building up to 10-20 minutes, once or twice a day.

Braden Kuo, MD, reviewed this article.