Irritable Bowel Syndrome (IBS) - western and yogic physiological

By Rachael Freeland

The following is an exploration of Irritable Bowel Syndrome (IBS) from both a western and yogic physiological perspective.  It aims to highlight both the similarities and the many differences between western and yogic physiology,

I hope you enjoy it

 
Dear Dr Dan and Swami Sattva,

I constantly suffer from a distressed Gastro-intestinal system (GI).  I experience continuous periods of constipation, which occasionally shift to diarrhoea, my stomach fills like a balloon, and the cramps in my abdomen are horrendous.  I’m sick and tired of feeling this way, of having no energy, and of not being able to do the things I want to do.  I’ve been told it might be irritable bowel syndrome, as tests have ruled out any abnormalities.  Can you please explain what is going on in my body, and what I could do to manage it better? 

Frustrated and Tired, Melbourne

Dr Dan: GP to the masses’ perspective

Dear F&T,
Irritable Bowel Syndrome (IBS) is certainly characterised by continuous or recurrent lower abdominal pain or cramping, and altered bowel motility (diarrhoea, constipation or both), which is similar to what you’ve described.  If you’re confident you’ve been properly diagnosed with IBS, there are several key points that will aid your understanding and management of this disorder.

1) With a predominant experience of constipation, it would be beneficial to increase your intake of fibrous foods.  In particular soluble fibre foods (eg rice, pasta, oatmeal), as these foods regulate the digestive tract, and stabilise intestinal contractions.  They do this by absorbing excess liquid in the colon to form a thick gel which the GI muscles can move quite easily.  Try to avoid non-soluble fibre foods (eg seeds, nuts, whole wheat, beans, lentils, leafy greens…), as these foods require digestion.  Also, ensure you drink enough liquids, as this enables the muscles to move the waste along the tract.    It is when the muscles struggle to move waste along the tract that the cramping and bloating you have described occur.  I would encourage you to get to know the types of foods that trigger abdominal cramping and agitation in you, as everyone is different.

2) Whilst IBS is indeed a physiological disorder, the other important factor in reducing its symptoms, is stress management.  Stress is an inescapable part of every-day life it keeps us alert to danger so we can keep ourselves safe.  However, it is important to learn strategies to manage stress, so that it doesn’t build up, causing damage to our system.   
A stressful event or experience stimulates the nervous system, sending messages to our brain/spinal cord that we need to prepare for “fight or flight.”  Messages are then sent all around our body.  The adrenal glands begin to secrete adrenaline, which work in conjunction with other chemicals to ready the body; we become alert, our breathing and heart rate increase, and blood is directed away from our organs to our muscles.  Digestion, and all activity associated with it is stopped, because it is an unnecessary bodily function in the face of this danger.  Once the stress passes, the body begins to relax, and messages are sent out in order to restore the balance, or homeostasis.  Homeostasis is essential to the body’s functioning.  It happens within all our physiological processes, all of the time, without us even being aware of it.      
The unfortunate thing with stress is that, if our body is not given sufficient time to relax, stressors can just build, and our body forgets to slow down.  This has a devastating effect on numerous systems, in particular the digestive system, as it stops and starts, and becomes quite unable to digest the food that has been consumed.  Given this stopping and starting, it is easy to see why you might feel tired, nauseous, and have no energy.  The difficulty with IBS is that stress prevents digestion occurring properly, and the inability to digest produces more stress.  Thus a vicious cycle is created.
Ultimately then, learning to relax your mind and body are essential allies here. Perhaps try exercising, maybe yoga, as it is reportedly quite beneficial for reducing/managing IBS symptoms, and try to do things that help you unwind. 

IBS is a “devastating and incurable condition that afflicts up to 20% of the worlds population.” (Heather, 1999).  Learning to manage it will help you to improve your quality of life, and to rise above its debilitating effects.  Good Luck.

Swami Sattva: a Yogi’s perspective

My learned friend, Dr Dan, has made some excellent points.  The physical body is incredible in the way it regulates itself and maintains this ‘homeostatic’ balance.  But whilst Dr Dan, has described this process on a physical level, the yogic perspective can help us to explore this balance on increasingly subtle levels.   From the yogic perspective, it is important to remember that what happens on a physical level (the body) creates blockages on other, subtler levels (including the mind), and vice versa.  These subtler levels are non-physical parts that overlie our physical bodies.  First we will explore some of these other levels so we can understand what might be going on in your body, then we’ll explore some options that will hopefully help you manage better.

Firstly, let’s look at the kosha’s.  The kosha’s are sheaths encasing the physical body.  There are 5 of these kosha’s:
 Annamaya kosha (Physical) which encompasses the physical body and its many different systems. 
 Pranamaya kosha (Energy) which encompasses the movement and flow of energy, throughout our system. 
 Manomaya kosha (Mental) which comprises our experiences with our lower mind, our senses, our reactions, our likes and dislikes,
 Vijnanamaya kosha (Wisdom) which is our intellect, our discernment and our wisdom, and,
 Anandamaya Kosha (Bliss) which is bliss, peace, contentment – (that which we all strive for!).

Much of what Dr Dan has described relates to Annamaya kosha.  The disruption and discomfort you feel here in your digestive system would also be experienced throughout the different levels of the subtle body, including pranamaya kosha.  The block here would affect the vayu’s, for it is the vayu’s within pranamaya kosha that are responsible for the flow of vital energy throughout the body.  There are 5 types of vayu’s, each of which would be weakened by the distress in your system. 
• Prana-vayu, is the forward moving vayu, it directs that which is coming into the body (i.e. food, breath). 
• Apana-vayu is the downward moving vayu, it directs that which is leaving the body i.e. urine, faecal matter, flatulence etc. 
• Udana-vayu is the upward moving vayu, it governs exhalation and speech. 
• Samana-vayu is centred at the abdominal region; it balances what comes in, with what goes out. 
• Vyana vayu is centred at the heart and is distributed throughout the entire body; it governs circulation, and the musculoskeletal system.

Your experience of constipation would create a block in apana vayu.  The balance then, between what is coming into and what is leaving the body is lost, disrupting samana vayu.  You might also begin to feel full, possibly nauseous, as it would be difficult for prana vayu to bring anything knew into the body.  You would probably feel lethargic too, as Vyana vayu would also be weakened.  The bouts of diarrhoea you describe would probably be apana vayu attempting to re-establish a balance in the system.  Each of these systems exists in a harmonious balance, and when the balance shifts in one system, it is felt across them all. 

Let’s look back again at the kosha’s. We have seen that your IBS symptoms have thrown your physical body (annamaya kosha), and your energetic body (pranamaya kosha) out of balance.  We also know that these systems work in harmony together.  So, as your awareness becomes fixated on the pressure in your system, you mind becomes focussed on these senses (i.e. the pain), on your emotions (i.e. the frustration), on your dislikes (i.e. IBS, possibly your body), and on your wants (i.e. to be able to process and eliminate food properly).  These experiences keep you centred in manomaya kosha, which make it difficult for you to access your higher self (vijnanamaya), let alone contentment and peace (anandamaya kosha). 

Now let’s look at the chakras.  The chakras are wheel-like energy centres that interconnect and communicate with the kosha’s and the vayu’s.  There are seven major chakras, which form a vertical pathway, called the sushumna (Anodea, 1999).  The sushumna exists in line with the spinal column, and like the spinal column acts as a “super highway” through which energy and messages travel.  Subsequently, as we have discussed earlier, the disturbance you have described, although it occurs at a physical level may have a connection to, or arise from a disturbance at an emotional, mental or spiritual level.  Of particular interest, are the following two chakras; Muladhara and Manipura.
 
Muladhara is the chakra found at the base of the spine.  It is the foundation of our entire system – on both a physical and
energetic level.  
At a physical level, it governs the foundation of our system, the solid parts of the body, including the bowel.  The issues related to the functioning of Muladhara are feelings of grounded-ness, and of fear    regarding security. 
 Grounded-ness pertains to connecting with the earth, with the tangible things in your world.  Feeling grounded strengthens Muladhara.  Ask yourself whether you spend a lot of time in your head, thinking? 
 Fear regarding security negatively impacts Muladhara.  When we feel fear, we activate our fight or flight response, and so stimulate our adrenal glands.  As Dr Dan explained, if you worry or feel stressed often, the constant stimulation of the adrenal glands may have a detrimental effect on your digestive system. 

Manipura is the third chakra, and is found at the solar plexus, over the adrenal glands (Anodea, 1996).  At a physiological level it rules over metabolism, of which the digestive system is an integral part.  Imbalances in this chakra often manifest as digestive disorders (Anodea, 1999), like IBS.  The central issue related to the functioning of Manipura is a sense of power.  When people feel afraid, or powerless, they withdraw into themselves.  This fear taps into Muladhara, and the self protective mechanisms people rely on to keep them safe. Sometimes people attempt to control what they say and do, so they fit with what is expected.  This controlling and self-protection can create blockages in the flow of, or deplete a person’s vital energy (this creates further disturbance in pranamaya kosha).  Often this can result in feeling lethargic, as you have described F&T.  Or it can manifest as a lack of strength, energy and/or will power to complete or achieve goals. 

Whilst I’m sure I may have overwhelmed you with information F&T, let me reassure you that there is hope.  Each of these energy centres, and subtle bodies can be cleared and balanced.  Yoga practise can be invaluable in this process, as it can alleviate tension from and clear energy blocks in the body and mind (Bhumi, 2003).  So speak to a teacher about developing a practise to suit your needs.  In the mean time, there are a number of things you can do to help manage your IBS symptoms, at the level of the body and the mind. 

1) If you start to balance what comes into your body with what goes out, you may begin to clear the disturbances in the vayu’s.  (This may seem simple, but don’t eat if you still feel full.  You might think eating will give you energy, but it will create further stress for your system).  Try perhaps to engage in some form of movement and activity, as this will begin to balance the stagnation and lethargy. 
2) Try to accept and work with your experience rather than fight it.  This is easier said than done I know, but by nurturing yourself in this way, you may be able to transcend the pain and discomfort.  This will enable you to begin to access vijnanamaya kosha, and the clarity and peace that it brings with it.
3) To begin to clear and balance Muladhara chakra, you might try bringing your awareness to and reconnecting with your body (through exercise, noticing the feeling of clothes on your skin, of the ground beneath your feet), and with the earth (by gardening, going for walks, spending time surrounded by nature).  This can be a powerful means of reducing the mind/body split, and ultimately grounding yourself (which as we said before, certainly strengthens Muladhara). 
4) To clear and balance Manipura chakra, begin nurturing yourself.  This will introduce a level of relaxation into your life.  Furthermore, by reconnecting with yourself (your body and mind) in a loving and accepting manner, you will begin to strengthen your self confidence, and help break the cycle of fear, withdrawal and the resulting loss of energy (If this is your experience).  You may even want to begin exploring your relationship with power, how comfortable are you with it? 

Take these suggestions as a guide, and explore those that resonate with you. - But have faith F&T; this is a process that may take some time.  Perhaps begin by simply becoming mindful of and accepting your own processes, reactions and limitations.  By exploring these, you may find you start making gradual shifts towards the life you want to be living.  As Gandhi said; “be the change you wish to see.”  Never be afraid to nurture yourself, and don’t be afraid to ask for help if you need it.  There are many services available to you, for counselling, support, education, and health. 

Good Luck and Take Care.

 

 
References

Anodea, J. (1996).  Eastern Body Western Mind:  Psychology and the Chakra System.  Celestial Arts Publishing, USA.

Anodea, J.  (1999).  Wheels of Life:  A user’s guide to the Chakra system.  Llewellyn Publications, USA.

Bhumi.  (2003).  Asana to aid digestion.  In ‘Australian Yoga Life’ (Issue 7).  Australian Yoga Life, Australia.

Class/Course Notes

Heather & Company.  Irritable Bowel Syndrome: Help For Pain, Diarrhoea & Constipation.  www.helpforibs.com

Pictures accessed from:  www.mysticfamiliar.com