P1191 - Efficacy and Safety of Shankha Prakshalana, a Yogic Technique versus Polyethylene Glycol Solution for Bowel Preparation in Colonoscopy: A Randomized Controlled Trial

Award: Presidential Poster Award

Award: Presidential Poster Award

Mohd Imran Chouhan, MD, Manas Kumar Panigrahi, DM, Rajesh Manik, PhD, Hemanta Kumar Nayak, DM, Sunil Jee Bhat, MD, Shivam Sethi, MD, Madhav Sameer Makashir, MD, Chandan Kumar, MD, Ajaya Ghosh R. U., MSc, M.P. Haridas, MBBS, Biswa Mohan, MD, Subash Chandra Samal, DM
All India Institute of Medical Sciences, Bhubaneswar, Orissa, India

Introduction: Bowel preparation is an important part of colonoscopy. Though several methods of bowel cleaning for colonoscopy are currently available, bowel preparation with Polyethylene glycol (PEG)-electrolyte solutions is the most commonly used one. Traditional yogic technique like “Shankha Prakshalana” (SP) has been known to clean bowel, but its efficacy for colonoscopy preparation has not been studied till date. We aimed to compare the efficacy and safety of SP with PEG in bowel cleaning for colonoscopy.

Methods: This was a single-blinded, randomized controlled trial including 60 adult patients requiring colonoscopy who were randomized into two groups: SP group (n=30) and PEG group (n=30). SP technique was done under supervision of a yoga trainer in the morning before colonoscopy. Patients were advised to drink 400 ml of lukewarm saline water followed by five asanas (exercises) of SP (Tadasana, Tiryaka tadasana, Katichakrasana, Tiryaka bhujangasana and Udarakarshanasana), each done eight times. This cycle was repeated five more times. The patients in the PEG group were given split dose preparation of PEG 3350 in two liters of water, split equally in two doses to be taken the night before and morning on the day of colonoscopy. All the patients were advised low fiber diet (< 10g/day) for one day before colonoscopy. Boston bowel preparation score (BBPS) was used to assess the bowel preparation in each group.

Results: The mean age in both the groups were comparable (44.47 ± 14.19 years in PEG group and 41.40 ± 15.00 years in SP group, p=0.42). Mean BBPS score for whole colon in PEG group and SP group was 7.73 ± 1.17 and 7.57 ± 1.19, respectively (p=0.58). Segmental BBPS for the 3 segments of colon (right, transverse and left) was also studied and no statistical difference was found between the two groups (Fig. 1). Nausea (30% in PEG group and 3.30% in SP group, p=0.012), bloating (20% in PEG group and none in SP group, p=0.024) and disturbed sleep (50 in PEG group and 16.7% in SP group, p=0.013) were significantly higher in PEG group as compared to the SP group.

Discussion: The traditional yogic technique of “Shankha Prakshalana” is comparable to standard PEG-electrolyte solution, as a method for colonoscopy preparation with better tolerability and less adverse effects.


Figure: Fig. 1. Mean Boston bowel preparation score (BBPS) of polyethylene glycol (PEG) group and Shankha Prakshalana (SP) group.


Disclosures:
Mohd Imran Chouhan indicated no relevant financial relationships.
Manas Kumar Panigrahi indicated no relevant financial relationships.
Rajesh Manik indicated no relevant financial relationships.
Hemanta Kumar Nayak indicated no relevant financial relationships.
Sunil Jee Bhat indicated no relevant financial relationships.
Shivam Sethi indicated no relevant financial relationships.
Madhav Sameer Makashir indicated no relevant financial relationships.
Chandan Kumar indicated no relevant financial relationships.
Ajaya Ghosh R. U. indicated no relevant financial relationships.
M.P. Haridas indicated no relevant financial relationships.
Biswa Mohan indicated no relevant financial relationships.
Subash Chandra Samal indicated no relevant financial relationships.


Mohd Imran Chouhan, MD, Manas Kumar Panigrahi, DM, Rajesh Manik, PhD, Hemanta Kumar Nayak, DM, Sunil Jee Bhat, MD, Shivam Sethi, MD, Madhav Sameer Makashir, MD, Chandan Kumar, MD, Ajaya Ghosh R. U., MSc, M.P. Haridas, MBBS, Biswa Mohan, MD, Subash Chandra Samal, DM. P1191 - Efficacy and Safety of Shankha Prakshalana, a Yogic Technique versus Polyethylene Glycol Solution for Bowel Preparation in Colonoscopy: A Randomized Controlled Trial, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.