Yoga and Celiac Disease

This post is published on The Huffington Post Blog.

I was diagnosed with celiac disease (“celiac”) in 2012. As a result, my life changed dramatically. What I thought would be a diet change turned out to be a lifestyle change affecting every part of my life – family, social, travel, and work. My symptoms ranged from the traditional gastrointestinal symptoms to extreme fatigue, lactose intolerance, and vitamin D insufficiency. Four years later, planning and preparing meals and monitoring and managing symptoms are now a normal part of my daily life. The new normal.
Celiac is a genetic[i], systemic autoimmune disorder caused by exposure to gluten.[ii] Gluten is a protein found in wheat, rye, and barley. The immune response activated in celiac when gluten is ingested causes the body to attack gluten as if it is an antigen. This immune response causes damage to the villi within the small intestine. According to the University of Chicago Celiac Disease Center, there are approximately 200 hundred recognized symptoms of celiac,[iii] including cancer, infertility, and depression. Celiac affects 1 in 133 people in the U.S. Currently, the only available and medically accepted treatment for celiac disease is the strict adherence to a gluten-free diet.[iv]

Patients with celiac must avoid ingestion and in some cases physical contact with anything that contains or has come in contact with gluten (wheat, barley, or rye). This includes food, cosmetics, beauty products, cleaning supplies, and medications that contain gluten. Exposure to gluten from any of these sources can also result in a celiac-related immune response and accompanying symptoms.

Upon diagnosis, I immediately eliminated gluten from my diet after my diagnosis and over the following 10 months eliminated gluten from my beauty products and cleaning supplies. Only then did I receive a negative blood test and “no exposure” declaration from my gastroenterologist. In order to heal my gut completely I adopted a whole foods diet free from grain, alcohol, dairy, soy, and processed foods for six months. Studies show that the intestinal damage caused by celiac can be healed over time by adherence to a gluten-free diet, although it is less successful in adults than children.[v]

One of the primary challenges of living with celiac is avoiding unintentional exposure to gluten, typically due to cross-contamination of gluten-free food with gluten-containing food (e.g. via cutting boards, grills, utensils, or medications) in restaurants. An inadvertent exposure causes symptoms similar to those at diagnosis. The treatment of symptoms from an exposure to gluten may include rest for fatigue and brain fog, anti-diarrheal medications for gastrointestinal symptoms, and eating whole, easily digestible foods and drinking lots of water. However, this varies based on the needs of the individual.

Two years after my diagnosis I started a relationship with yoga, which as grown quickly and significantly. I practice Hatha and vinyasa flow yoga in the lineage of Krishnamacharya and Shiva Rea. I am now a registered yoga instructor (RYT200), trained at Pranayoga Institute of Yoga and Holistic Health. I was drawn to yoga for stress relief but have found it a great tool for gastrointestinal health and support for celiac symptoms.

However, there are no studies investigating a connection between yoga and celiac disease. Current medical research on yoga and gastrointestinal disorders is focused mainly on irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Similar to celiac, IBS and IBD symptoms include anxiety, depression, headaches,[vi] severe diarrhea, abdominal pain, cramping, weight loss, and fatigue.[vii]

In a study of patients with IBS practicing yoga once a week for 6 weeks improvement was found in the patients’ symptoms, including fatigue, physical functioning, and abdominal pain.[viii] Quality of life scores and functional abdominal pain improved in a study of 20 patients with IBS after practicing yoga for 12 weeks.[ix] Patients with IBS who practice one hour of yoga at home via a video-guided practice experienced improved gastrointestinal symptoms and decreased pain.[x] Additionally, the patients indicated that they would continue practicing yoga because it was beneficial to them. These studies demonstrate a pattern of improved symptoms and enhanced quality of life among those with gastrointestinal symptoms who practice yoga.

I have found that my yoga practice generally improves my health (mind and body) and specifically helps manage my digestive process. After two years of regular yoga practice with pranayama and inconsistent meditation I have found poses and techniques that help with specific symptoms. When I am experiencing constipation and other gastrointestinal symptoms I rely on balasana (child’s pose), apanasana (knees into chest or full gas release pose), viparita karani (legs up the wall), malasana (squat), and supta baddha konasana (reclining butterfly) to assist in elimination and relief. Apanasana or knees into the chest pose done with a micro-dynamic movement in and out with the breath (inhale and move the knees out as far as the arms will extend and exhale bring them back into the chest) provides immediate relief to bloating due to gas and constipation. And when I am experiencing extreme fatigue pranayama (alternate nostril breath and other deep breathing) and a balanced Hatha practice increase my energy level and help me to sleep better.

FullSizeRender 2Yoga certainly isn’t magic but the management of my digestive health and symptoms have improved since I began practicing yoga. Whether the improvement is a result of decreased stress and increased relaxation that comes from yoga or a direct physiological response to certain movements, I can’t be certain.

It is difficult to separate the whole body, wellness, and life experience into parts that isolate what activities affect certain conditions. However, for me it is clear that the holistic practice of yoga supports the healthy functioning of my body as a whole – mentally, emotionally, and physically.

Many of the same symptoms and body processes present across gastrointestinal diseases, including IBS, IBD, and celiac disease. Given the scientific evidence and my experience, it is an easy leap to suggest that a regular yoga practice can lead to positive outcomes for people with celiac and other gastrointestinal diseases or distress.

Ultimately, every body is different and each person must know how their body responds to their specific condition. That awareness will aid in finding the right physical yoga practice to feel whole and well again. Because, yoga is for everyone.

 

[i] Celiac Disease. U. S. National Library of Medicine website. https://ghr.nlm.nih.gov/condition/celiac-disease. Updated May 10, 2016. Accessed May 11, 2016.

[ii] Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases website. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx#what. Updated June 2015. Accessed May 11, 2016.

[iii] Symptoms of Celiac Disease. The University of Chicago Medicine Celiac Disease Center website. http://www.cureceliacdisease.org/symptoms/. Accessed May 11, 2016.

[iv] Treatment of Celiac Disease. The University of Chicago Medicine Celiac Disease Center website. http://www.cureceliacdisease.org/treatment/. Accessed May 11, 2016.

[v] Celiac Disease – Sprue. U. S. Library of Medicine Medline Plus website. https://www.nlm.nih.gov/medlineplus/ency/article/000233.htm. Updated February 21, 2014. Accessed May 11, 2016.

[vi] Kavuri V, Raghuram N, Malamud A, Selvan SR. Irritable Bowel Syndrome: Yoga as Remedial Therapy. Evid based Complement Alternat Med : eCam. 2015;2015:398156. doi: 10.1155/2015/398156.

[vii] Mayo Clinic. Diease and Conditions: Inflammatory Bowel Disease. Available at: http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/symptoms/con-20034908. Updated: February 18, 2015. Accessed: March 14, 2016.

[viii] Evans S, Lung KC, Seidman LC, et al. Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome. J Pediatr Gastroenterol Nutr. 2014; 59(2):244-253. doi:10.1097/MPG.0000000000000366.

[ix] Brands M, Purperhart H, Deckers-Kocken J. A Pilot Study of Yoga Treatment in Children with Functional Abdominal Pain and Irritable Bowel Syndrome. Compliment Ther Med. 2011.19(3) 109-114.

[x] Kuttner L, Chambers CT, Hardial J, Israel DM, Jacobson K, Evans K. A randomized trial of yoga for adolescents with irritable bowel syndrome. Pain Res Manag : The Journal of the Canadian Pain Society. 2006; 11(4):217-224.

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What Happens When You Get a Bug in Your Ear

One of my very favorite southern sayings is “like a duck on a June bug.” You know, he was all over her like a duck on a June bug or like white on rice. I have friends who had a great time as kids tying strings to the legs of June bugs and watching them fly in circles.

These things make June bugs seems charming, even cute.

They are not.

This summer I came face-to-face, well, ear to body, with a June bug. We went to the woodshed and I survived, but it wasn’t pretty.

JPEG image-7BC76CC603FD-1I was enjoying an evening at the Romp Bluegrass Festival in Owensboro, Kentucky. It was a lovely evening, despite the tiny little chairs we brought to sit on for hours. In an effort to relieve our rear-ends we laid on a blanket in the grass. It was just like a country song – laying under the stars with your boyfriend listening to music and enjoying a warm summer night. It was until, without warning, a bug flew into my right ear.

This wasn’t just a bug crawling on my head. This bug dive-bombed my ear and was in my ear canal before I could raise my hand to swat it away.

What happened next was mostly a blur of me crying, screaming, and dancing around trying to get the moving, wing flapping, biting, and scratching bug out of my ear. I can only imagine what the other concertgoers thought as they watched me. In a moment of desperation I opened our Nalgene bottles and poured water in my ear. By the time we reached the security tent the June bug stopped moving. I was relieved that the pain had stopped and horrified that I was bleeding from my ear and had a dead bug in my head.

The kind security guard called for a cart to take me to the EMT (the first aid tent closed at 8:00 p.m.) and talked to me until it arrived. Very encouraging. But that feeling quickly faded when the cart arrived. The driver, a man I can only describe as Bubba, told me to get in. He was accompanied by what appeared to be his girlfriend and her little sister, who was holding a dog. I explained the problem and the little girl, sitting next to me, said “you can get a bug in your ear?” I braced myself.

We started down the narrow road, carving a path through the concertgoers who were surely camping (all night – long after first aid closed). I noticed the cart slowing and heard Bubba call out to a man at our right as he stopped the cart to say, “hey man how’s it going?” I was near the end of my rope, as nicely as I could I said “dude, seriously?” He promptly starting moving and announcing that there was a “woman in the cart who is bleeding.” This did not do much to move the crowd.

We arrived at the ambulance. The EMT was not there. But in the distance we saw a small form running toward us. He arrived and while nice he seemed about 19. He looked in my ear and promptly declared that he could not see anything, “could not do anything” for me and that I would have to go to the hospital.

We explained that we are from out of town and aren’t familiar with Owensboro or the hospital. He attempted the give us directions, which culminated in, “Do you have GPS? Use that.”

We walked silently back to the car. In the dark. In the middle of a field in Owensboro, Kentucky.

I started to cry – the I-am-at-the-end-of-myself slow weeping – as I opened my Google Maps app and found the directions to the hospital. It was nearby.

I walked into the emergency room and spoke to the nice lady at the registration desk. I gave her my information and story with big tears rolling down my cheeks. She sweetly asked if I was alone, I said no and that I am from out of town. She tilted her head and looked at me as only an elderly southern woman can and said slowly and sweetly, “bless your heart.”

Then we sat in the waiting room for an hour, my head in the only position that wasn’t painful and bleeding on my boyfriend’s shirt.

After an hour they called my name. I went back and met with a cheery physician’s assistant who wanted to know “what’s going on tonight?” Through my now dry swollen eyes I explained that there is a bug in my ear.

He took a look in my ear and proclaimed that he “could see something brown and it could be a bug, but it could be earwax.” He does not know how close he came to getting smacked in the face. I calmly but condescendingly explained that I could feel the bug moving in my ear (back when it was alive) and I am certain that is not earwax. Suddenly, he was a bit more motivated to take a closer look.

We went into a procedure room where I promptly refused to lay on the bed because there was a distinctive looking black hair on it. We moved rooms. He was annoyed. I was indignant.

I laid down on my side in the clean room. The PA took forceps with a long nose and immediately dove into my ear. I immediately screamed and insisted on sitting up. As I did I watched as he examined a tiny piece of something he pulled out of my ear, which he described as “not part of your ear.” Duh.

Meanwhile, I was reeling from the pain. He did not warn me that taking whatever was in there out would be far more painful than when it went in (and that was very painful). I asked, nearly begged, if there was another way? He offered irrigation but said it might cause the bug to break apart and that did not seem desirable.

So, I braced myself, squeezed my sweet boyfriend’s hand, and employed my yoga breathing as he made 3 more pulls from my ear. The last drew out the bulk of the bug’s body to which he exclaimed “oh my God.” Turns out, it was a bug. I exclaimed, “thank you, Jesus.”

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I thought we were finished, but he explained that he thought that there was a leg left behind in my ear (we counted only five on the bugs body). He could not go searching for it because of the blood and swelling and danger for my eardrum, but “it isn’t a big deal, it will come out in wax.” Easy for him to say, he didn’t have a bug leg in his ear.

JPEG image-3E68EC8E76E1-1I was release from the hospital a short time later. The next day we returned to the festival (I wore ear plugs), listened to some great music, and celebrated me not having a bug in my ear.

I am still okay with bugs and my ear no longer hurts, but I’ll never hear the old saying “put a bug in someone’s ear” quite the same way ever again.