Weekly yoga sessions may be associated with a better quality of life for patients with ulcerative colitis, a chronic inflammatory bowel disease that can be exacerbated by stress, a small study suggests.

People with ulcerative colitis have inflammation in the lining of the large intestine that can lead to symptoms like diarrhea and abdominal pain. When symptoms are severe, patients may have sudden loose or bloody stools so often that it impairs their ability to navigate normal daily activities like going to school or work.

Researchers studied 77 ulcerative colitis patients who reported a reduced quality of life due to the disease even though their symptoms were clinically in remission. They randomly assigned participants to receive either 12 weekly yoga sessions or written self-care advice and found the yoga group had greater improvements in quality of life.

“It seems to be safe and effective, so it is surely worth trying yoga as an add-on to other evidence-based interventions at least for maintenance of remission,” said lead study author Dr. Holger Cramer, a researcher at the University of Duisburg-Essen in Germany.

“It definitely should not be used as a replacement but rather as an ancillary intervention,” Cramer said by email. “That’s how it was used in our study.”

Previous research has linked higher perceived stress levels to more severe ulcerative colitis symptoms, and other studies have also tied yoga to reduced stress in both healthy and sick people, researchers note in the journal Alimentary Pharmacology and Therapeutics.

While there isn’t a standard treatment regimen that’s the same for all patients with ulcerative colitis, they may take a variety of different drugs to curb inflammation and achieve symptom remission. In more severe cases, they may need surgery to remove the colon and rectum.

At the start of the current study, patients had been in remission for at least four weeks and no longer than one year.

People were excluded if they weren’t in remission and had active symptoms, if they had surgery to remove their colon, or if they had medical problems that would make it hard for them to do even light yoga exercises.

Patients assigned to yoga during the study took 90-minute classes in what’s known as hatha yoga, with postures and breathing exercises designed to calm the body and mind. People in the yoga group were also given manuals to try poses at home and encouraged to keep a daily log of their practice time.

Everyone in the control group of self-care patients received two books with general information on ulcerative colitis and strategies for improving symptoms with lifestyle modifications, medication and other approaches. They were asked not to start a yoga practice or any other exercise regimen during the study.

With yoga, people reported a better quality of life after 12 weeks of classes, and again three months later.

Five patients in the yoga group had side effects like musculoskeletal pain that may have been related to the yoga, while none of the mild side effects in the self-care group appeared related to this intervention.

One limitation of the study is that many patients dropped out of the yoga class, mainly because it proved too time consuming, the authors note. It’s also possible that personal attention from yoga instructors contributed to outcomes for that group rather than the yoga itself, the researchers point out.

Still, some previous studies suggest that stress reduction may have direct anti-inflammatory effects, which may explain why yoga reduced disease activity and flares in patients with ulcerative colitis in the current study, said Dr. Gilaad Kaplan, a gastroenterologist, at the University of Calgary in Canada.

“Yoga should not replace the medications that help patients with ulcerative colitis go into remission,” Kaplan, who wasn’t involved in the study, said by email. “But yoga may serve as complementary intervention, particularly in patients experiencing stress or whose quality of life is poor.”