BHUBANESWAR: Yoga can be a better, more effective and safer alternative to conventional medical procedure for bowel preparation before colonoscopy, a study by doctors at AIIMS-Bhubaneswar has found.
Sankhaprakhsalana (SP) – a combination of five asanas – has proved to enable optimum bowel cleansing for colonoscopy sans side-effects, and in significantly shorter time duration. Over 99 per cent of patients who undertook the specific yogasanas achieved adequate and good-quality bowel preparation for colonoscopy compared to 65 to 85 per cent adequacy rate with conventional medical agents.
The asanas involve consumption of warm saline water followed by sequential performance of five postures that result in complete evacuation of fecal matter and food residue from the bowel, rendering the colon clean and lubricated for effective examination.
Bowel preparation is the most important part of colonoscopy. Inadequate preparation results in increased procedure time, missed lesions, failure to intubate the cecum, adverse events and also cancelled colonoscopy appointments and increased costs. Pre-colonoscopy preparation is measured on Boston Bowel Preparation Scale (BBPS) of at least six or more.
Polyethylene glycol (PEG), the most used procedure, involves more than 10 hours preparation with split doses overnight and morning before the colonoscopy. The disadvantages of using PEG include consumption of a relatively large volume of solution, inconvenient timing of consumption, disturbed sleep, poor palatability, bloating, cramps, nausea and vomiting.
“On the other hand, Sankhaprakhsalana method took around two hours. With as many as 238 patients included in the observational study, the overall mean BBPS score was around eight, substantially higher than the adequate range and conventional medical agents,” said study lead additional professor gastroenterology department of AIIMS-Bhubaneswar, Dr Manas Kumar Panigrahi.
The SP was performed under the supervision of a yoga trainer on the day of colonoscopy starting at 8.30 am. Participants completed eight cycles of Tadasana, Tiryaka Tadasana, Katichakrasana, Tiryaka Bhujangasana and Udarakarshanasana while consuming warm saline water in between.
In yogic texts, it is postulated that Tadasana opens pyloric sphincter, Tiryaka Tadasana contracts the small intestine, Katichakrasana twists the intestine, which helps in the distal passage of stool, Tiryaka Bhujangasana opens the ileocecal valve and Udarakarshanasana causes alternate contraction and relaxation of the large intestine facilitating expulsion of fecal matter from the colon.
“Our study is the first-of-its-kind to evaluate the efficacy of yoga in bowel preparation on a large number of patients, and it has aptly demonstrated. Not only is it more effective, the most important factor is convenience for patients. With medical agents, it is an overnight anxiety-ridden affair while with yoga it was complete in just around two hours,” Dr Panigrahy stated.
The study has been published in the Indian Journal of Gastroenterology.