Journal Article Annotations
2021, 3rd Quarter

GI Psychiatry

Annotations by Ashwini Nadkarni, MD
September, 2021

Effects of yoga in inflammatory bowel diseases and on frequent IBD-associated extraintestinal symptoms like fatigue and depression.

PUBLICATION #1 — GI Psychiatry

Effects of yoga in inflammatory bowel diseases and on frequent IBD-associated extraintestinal symptoms like fatigue and depression.

E Wilke, W Reindl, P A Thomann, M P Ebert, T Wuestenberg, A K Thomann

Abstract: Complement Ther Clin Pract. 2021 Jul 29;45:101465.

Quality of life (QoL) of persons with inflammatory bowel diseases (IBD) is often impaired by symptoms that do not primarily relate to intestinal inflammation. Among the most challenging extraintestinal symptoms are depression and fatigue, which are also frequent in other chronic diseases like multiple sclerosis, rheumatoid arthritis and cancer. Yoga as an ancient Indian tradition containing postures, breathing exercises and meditation may positively influence those symptoms. This review evaluates the current literature with regard to the effect of yoga-based interventions in persons with IBD and with regard to QoL, depression and fatigue in other somatic disorders. A systematic literature search yielded three trials examining the effects of yoga in patients with IBD and 37 trials addressing depressive syndromes or fatigue in somatic disorders. In summary, both in-person and video-based yoga classes are feasible, acceptable and safe as complementary treatment in patients with IBD and significantly improve anxiety and impaired quality of life. Current literature does not provide information on the effect of yoga on depression and fatigue in patients with IBD, but research from other somatic disorders or patients with depressive disorders implies the potential of yoga in this regard for persons with IBD. This should be specifically addressed in interventional trials with standardized yoga modules including patients with IBD suffering from fatigue, depression and/or impaired QoL.

Annotation

The finding:
Depression and fatigue are persistent symptoms in patients with IBD and often refractory to intervention. Yoga has been shown to be effective for the treatment of such symptoms in other medical conditions. In this systematic literature review, the investigators identified forty trials of patients with IBD and somatic symptom disorders. They conclude that yoga can improve quality of life in people with IBD who have depression and fatigue.

Strength and weaknesses:
To reliably measure replicable effects in yoga trials and promote yoga as a reliable therapeutic option for patients with IBD, standardized modules are required. No IBD-specific yoga protocol has been established. Additionally, while this review did include several large, randomized controlled trials, most of the articles examined were smaller, case-control studies. Finally, the studies examined did not assess patients with active IBD symptoms.

Relevance:
Fatigue is a symptom that often results in referrals from gastroenterology to C-L psychiatry but also overlaps with symptoms of depression. This article is an invaluable reference for psychiatrists who are treating IBD patients with fatigue and depression.