Effect of Yoga-Based Intervention in Patients with Inflammatory Bowel Disease.

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic illness characterized by gross inflammation in the gastrointestinal tract that can result in symptoms such as abdominal pain, cramping, diarrhea, and bloody stools. IBD is believed to be influenced by psychological factors such as stress and anxiety. Therefore, a yoga intervention that reduces stress and anxiety may be an effective complementary treatment for these disorders. MATERIAL AND METHODS: A total of 100 IBD patients [ulcerative colitis (UC) n = 60 and Crohn's disease (CD) n = 40] during the clinical remission phase of disease were included in the study. These patients were allocated randomly to either the yoga group that underwent an 8-week yoga intervention (physical postures, pranayama, and meditation) 1- hour/day in addition to standard medical therapy (UC, n = 30; CD, n = 20) or the control group (UC, n = 30; CD n = 20), which continued with standard medical therapy alone. The main outcome measures were cardiovascular autonomic functions, serum eosinophilic cationic protein, interleukin- 2 soluble receptors, Speilberger's State Trait Anxiety Inventory (STAI) scores, and clinical symptoms. RESULTS: Before the intervention, all the outcome measures were comparable in the two groups. After the 8-week yoga intervention, fewer UC patients reported arthralgia. The number of patients reporting intestinal colic pain in the control group was higher. State and trait anxiety levels were significantly reduced in patients with UC. However, no significant changes were observed in cardiovascular autonomic functions, eosinophilic cationic proteins, or interleukin-2 soluble receptors. CONCLUSIONS: A simplified yoga-based regimen is a safe and effective complementary clinical treatment modality for patients with inflammatory bowel disease during the clinical remission phase.

Autonomic dysfunction due to lead poisoning.

We present a case history of a 24 years old male who developed autonomic dysfunction, intestinal pseudo-obstruction and anemia due to lead poisoning. Concomitant recording of blood levels of lead and autonomic function showed a gradual decline in blood lead level (98.8 microg/dL at week 0, 56 microg/dL at week 6, and 40 microg/dL at week 52) and gradual improvement in autonomic functions. Decrease in blood lead levels with DMSA (Meso-2, 3-dimercaptosuccinic acid) therapy showed improvement in autonomic functions. At week 0, the patient had severe loss of autonomic tone and autonomic reactivity which improved at week 6. At the 52nd week, most of the autonomic parameters had normalized except for the persistence of mild loss of parasympathetic reactivity.

Autonomic status in systemic sclerosis in India.

Systemic sclerosis (SSc) is a systemic connective tissue disease characterized by vasomotor disturbances. Autonomic dysfunction has been implicated in the pathogenesis of various symptoms in patients with SSc. In this retrospective study, thirty patients with SSc as cases and thirty age matched healthy subjects were enrolled as controls. The patients as well as controls were subjected to a standard battery of autonomic tests including reactivity and activity (tone) tests. Resting autonomic variables like blood pressure (BP), heart rate (HR) and respiratory rate (RR) were also recorded. In our study, we found significantly higher HR and RR in the patient group (P = 0.0001 and 0.012 respectively). We also observed significantly lower parasympathetic tone and parasympathetic reactivity in SSc patients than the controls. This study shows the status of autonomic functions in SSc patients in India, with lower central parasympathetic drive to the heart. The present study may give some insight for better understanding of this multisystem disorder of unknown etiology.