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.