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Yoga for Teens With Irritable Bowel Syndrome: Results From a Mixed-Methods Pilot Study.

ABSTRACT: Irritable bowel syndrome (IBS) is a common condition associated with recurrent abdominal pain and altered bowel habits. It is particularly pernicious to youth, who may withdraw from life tasks due to pain, diarrhea, and/or fear of symptoms. Emotional stress exacerbates IBS symptoms, and mind-body interventions may be beneficial. In this mixed-methods study of 18 teens aged 14 to 17 years undertaking a 6-week Iyengar yoga intervention, we aimed to identify treatment responders and to explore differences between responders and nonresponders on a range of quantitative outcomes and qualitative themes related to yoga impact, goodness of fit, and barriers to treatment. Half of the teens responded successfully to yoga, defined as a clinically meaningful reduction in abdominal pain. Responders differed from nonresponders on postintervention quantitative outcomes, including reduced abdominal pain, improved sleep, and increased visceral sensitivity. Qualitative outcomes revealed that responders reported generalized benefits early in treatment and that their parents were supportive and committed to the intervention. Responders and nonresponders alike noted the importance of home practice to achieve maximal, sustained benefits. This study reveals the need for developmentally sensitive yoga programs that increase accessibility of yoga for all patients.

SUBMITTER: Evans S

PROVIDER: S-EPMC6283406 | biostudies-literature | 2018 Sep/Oct

REPOSITORIES: biostudies-literature

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Yoga for Teens With Irritable Bowel Syndrome: Results From a Mixed-Methods Pilot Study.

Evans Subhadra S Seidman Laura C LC Lung Kirsten K Sternlieb Beth B Zeltzer Lonnie K LK

Holistic nursing practice 20180901 5

Irritable bowel syndrome (IBS) is a common condition associated with recurrent abdominal pain and altered bowel habits. It is particularly pernicious to youth, who may withdraw from life tasks due to pain, diarrhea, and/or fear of symptoms. Emotional stress exacerbates IBS symptoms, and mind-body interventions may be beneficial. In this mixed-methods study of 18 teens aged 14 to 17 years undertaking a 6-week Iyengar yoga intervention, we aimed to identify treatment responders and to explore diff ...[more]

PMID: 30113959

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Project description:IntroductionIrritable bowel syndrome affects as many as 14% of high school-aged students. Symptoms include discomfort in the abdomen, along with diarrhea and/or constipation and other gastroenterological symptoms that can significantly impact quality of life and daily functioning. Emotional stress appears to exacerbate irritable bowel syndrome symptoms suggesting that mind-body interventions reducing arousal may prove beneficial. For many sufferers, symptoms can be traced to childhood and adolescence, making the early manifestation of irritable bowel syndrome important to understand. The current study will focus on young people aged 14-26 years with irritable bowel syndrome. The study will test the potential benefits of Iyengar yoga on clinical symptoms, psychospiritual functioning and visceral sensitivity. Yoga is thought to bring physical, psychological and spiritual benefits to practitioners and has been associated with reduced stress and pain. Through its focus on restoration and use of props, Iyengar yoga is especially designed to decrease arousal and promote psychospiritual resources in physically compromised individuals. An extensive and standardized teacher-training program support Iyengar yoga's reliability and safety. It is hypothesized that yoga will be feasible with less than 20% attrition; and the yoga group will demonstrate significantly improved outcomes compared to controls, with physiological and psychospiritual mechanisms contributing to improvements.Methods/designSixty irritable bowel syndrome patients aged 14-26 will be randomly assigned to a standardized 6-week twice weekly Iyengar yoga group-based program or a wait-list usual care control group. The groups will be compared on the primary clinical outcomes of irritable bowel syndrome symptoms, quality of life and global improvement at post-treatment and 2-month follow-up. Secondary outcomes will include visceral pain sensitivity assessed with a standardized laboratory task (water load task), functional disability and psychospiritual variables including catastrophizing, self-efficacy, mood, acceptance and mindfulness. Mechanisms of action involved in the proposed beneficial effects of yoga upon clinical outcomes will be explored, and include the mediating effects of visceral sensitivity, increased psychospiritual resources, regulated autonomic nervous system responses and regulated hormonal stress response assessed via salivary cortisol.Trial registrationClinicalTrials.gov NCT01107977.

Project description:BACKGROUND: Increased concentrations of 5-hydroxytryptamine (5-HT) can be detected in the systemic circulation after a meal and may be involved in the physiological control of gastrointestinal motility. Abnormalities of 5-HT release after a meal might explain some of the postprandial symptoms associated with the irritable bowel syndrome (IBS). AIM: To investigate the effect of a standard meal on plasma 5-HT and urinary 5-hydroxyindole acetic acid (5-HIAA) concentrations in patients with diarrhoea predominant IBS and in healthy volunteers. METHODS: After an overnight fast, six volunteers and five patients with IBS were given a carbohydrate-rich meal. Blood and urine samples were taken before and for four hours after the meal. Platelet-poor plasma 5-HT and urinary 5-HIAA were analysed by reversed phase high performance liquid chromatography with fluorometric detection. 5-HIAA was expressed as a ratio with urinary creatinine concentration, which was measured by spectrophotometry. RESULTS: During the four hour postprandial period, 5-HT concentrations were significantly higher in patients with IBS than in healthy volunteers at 0.5 hours (p < 0.05), 2 hours (p < 0.05) and 2.5 hours (p < 0.05). 5-HT was not detected in the plasma in the fasting state in patients or volunteers. Median peak 5-HT in patients with IBS (359 (198-796) nmol/l) was significantly greater than volunteers (83 (7-190)) (p < 0.05). "Area under the curve" for 5-HT detection was greater for patients with IBS (317 (138-771)) than for healthy volunteers (51 (4-129); p < 0.05). The duration of the 5-HT peak was significantly longer in patients with IBS (3 (1-3) hours) than in the healthy volunteers (1 (1-1) hours; p < 0.01). Postprandial urinary median 5-HIAA values in controls (5.6 (5.5-5.8) mumol/mmol creatinine) and patients with IBS (3.0 (2.5-6.8) mumol/mmol creatinine) were not significantly different from preprandial values (controls: 5.9 (5.5-6.6) mumol/mmol creatinine; patients with IBS: (6.2 (2.4-9.3) mumol/mmol creatinine). CONCLUSION: These findings indicate that there may be a difference in the way that 5-HT is released in patients with diarrhoea predominant IBS, and could suggest a possible role for 5-HT in the postprandial symptoms of these patients.

Dataset Information

Yoga for Teens With Irritable Bowel Syndrome: Results From a Mixed-Methods Pilot Study.

Publications

Yoga for Teens With Irritable Bowel Syndrome: Results From a Mixed-Methods Pilot Study.

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