Study reveals how relaxation response may help treat 2 gastrointestinal disorders

A pilot study has found that participating in a nine-week training program including elicitation of the relaxation response had a significant impact on clinical symptoms of the gastrointestinal disorders irritable bowel syndrome and inflammatory bowel disease and on the expression of genes related to inflammation and the body's response to stress. The report from investigators at the Benson-Henry Institute at Massachusetts General Hospital (MGH) and at Beth Israel Deaconess Medical Center (BIDMC), published in the open-access journal PLOS ONE, is the first to study the use of the relaxation response in these disorders and the first to investigate the genomic effects of the relaxation response in individuals with any disorder.

"Our results suggest exciting possibilities for further developing and implementing this treatment in a wider group of patients with gastrointestinal illness," says Braden Kuo, MD, of the Gastrointestinal Unit in the MGH Department of Medicine, co-lead author of the PLOS ONE report. "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 in IBS."

Both IBS and IBD are chronic conditions that produce related symptoms, including abdominal pain and changes in bowel function such as diarrhea. But while IBD - which includes Crohn's disease and ulcerative colitis - is characterized by severe inflammation in all or part of the gastrointestinal tract, no inflammation or visible abnormality is present in IBS. Stress appears to exacerbate both conditions, and since the symptoms themselves can increase stress in patients, finding ways to break that vicious cycle could have significant clinical benefits.

The relaxation response - a physiologic state of deep rest induced by practices such as meditation, yoga and prayer - was first described more than 40 years ago by Herbert Benson, MD, director emeritus of the Benson-Henry Institute and a co-author of the current paper. Many studies have shown that regular practice of the relaxation response not only alleviates stress and anxiety but also directly affects physiologic factors such as blood pressure, heart rate and oxygen consumption. In reports published in 2008 and 2013 Benson, Towia Libermann, PhD and Manoj Bhasin, PhD - both of the BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center - described finding how elicitation of the relaxation response in healthy individuals affects the expression of genes in pathways involved with the body's response to stress, inflammation and energy metabolism. Libermann is co-senior author and Bhasin is co-lead author of the current study.