Relaxation Responses for Gastrointestinal Disorders

Relaxation responses‑‑physiologic states of deep rest induced by practices such as meditation, yoga, and prayer‑‑were reported to positively trigger symptom improvement and gene expression changes within patients afflicted with gastrointestinal disorders like irritable bowel syndrome and inflammatory bowel disease.

The 9-week training program, highlighted by investigators at the Benson-Henry Institute, Massachusetts General Hospital (MGH) and the Beth Israel Deaconess Medical Center (BIDMC), investigated the “genomic effects of the relaxation response in individuals with any disorder”.

The study enrolled 48 adult participants (19 with IBS and 29 with IBD) who were asked to practice 15 to 20 minutes of daily relaxation response elicitation at home. Additionally this program included a session specifically focused on gastrointestinal health.

The individuals were assessed at the beginning, midway through, at the end of the program, and then 3 weeks later using standardized tools for measuring symptoms common to both disorders.

Researchers noted participation in the mind/body program appeared to significantly improve disease-related symptoms, anxiety and overall quality of life, not only at the end of the study period but also 3 weeks later — both in patients with IBS with IBD.

Despite no significant changes in inflammatory markers, the team observed changes in expression in approximately 200 genes among participants with IBS and more than 1,000 genes in those with IBD.

It was important to note that several of the altered genes wereconsidered to contribute to pathways involved with stress response and inflammation.

Co-senior author John Denninger, MD, PhD, of the Benson-Henry Institute at MGH commented, "One interesting clinical impact was a decrease in both IBS and IBD patients in what is called pain catastrophizing - a negative cognitive and emotional response to pain or the anticipation of pain. In other words, participants became more resilient in the face of the pain they were experiencing. But before we can offer a program like this to patients with these disorders, we'll need to conduct a longer, randomized trial with a control group and enough participants for statistically significant results."

Braden Kuo, MD, Gastrointestinal Unit, MGH Department of Medicine, co-leader author of the report said, “Our results suggest exciting possibilities for further developing and implementing this treatment in wider group of patients with gastrointestinal illness.”

Kuo concluded, “Several studies have found that stress management techniques and other psychological interventions can help patients with IBS, at least in the short term; and while the evidence for IBD is less apparent, some studies have suggested potential benefits. What is novel about our study is demonstration of the impact of a mind/body intervention on the genes controlling inflammatory factors that are known to play a major role in IBD and possibly IBS.”