Assessing the Effectiveness of a Stress Reduction Intervention in Inflammatory Bowel Disease (IBD)

Assessing the Effectiveness of a Stress Reduction Intervention in Inflammatory Bowel Disease (IBD): a Prospective Randomized Controlled Trial (RCT)

The investigators have designed a guided, online, tri-component, stress reduction intervention for participants with inflammatory bowel diseases.

In a randomized controlled trial, the investigators assessed the impact of an online, 3-month stress reduction intervention (yoga, breathwork, and meditation). The primary outcome was the change in Cohen's Perceived Stress Scale (PSS) between the control and intervention arms. The following secondary outcomes were also assessed: anxiety, depression, IBD disease activity (e.g., changes in CRP, fecal calprotectin, medication, hospitalization, or surgery), serum inflammatory markers, serum and salivary markers of stress, stress-resilience, and health- related quality of life. Participant satisfaction and adherence to the intervention were also evaluated.

Inclusion Criteria (RCT):

• Adults (≥18 years)
• with IBD in remission (UC - partial Mayo <2 and fecal calprotectin <250 μg/g; CD regular HBI <5 or CRP <8)
• on stable therapy for the past 3 months
• the last flare <24 months prior to enrollment
• PSS-10 score ≥ 7 at time of screening

Inclusion Criteria (Substudy):

• Adults (≥18 years)
• IBD
• on stable therapy for the past 3 months.

Exclusion Criteria (RCT or Substudy):

• Major medical co-morbidity
• Steroid use in past 3 months
• Clostridium difficile infection in the last 3 months
• Unstable dose of psychiatric medications for the last 3 months
• Inability to provide informed written consent
• Severe psychiatric disorders (HADS scores >10 or suicidal ideation)