Abstract
BACKGROUND AND AIMS: The traditional yogic technique of shankha prakshalana (SP) has been known to cleanse the bowel, but its efficacy as a bowel preparation agent in colonoscopy has not been studied widely. We compared the efficacy and safety of SP with split-dose polyethylene glycol (PG) in bowel preparation for colonoscopy. METHODS: Patients undergoing elective colonoscopy were randomized into 2 groups: PG group (n = 47) and SP group (n = 47). Patients in the PG group were given 2 liters of PG 3350 in a split-dose regimen. Patients in the SP group were administered 400 mL of lukewarm saline water followed by a set of 5 asanas (physical exercises) of SP, with each asana performed 8 times under the supervision of a certified yoga trainer (R.M.). This constituted 1 cycle, which was repeated 6 times (total intake of 2400 mL lukewarm saline water). The Boston Bowel Preparation Scale (BBPS) was used to assess the main outcome of the efficacy of bowel preparation. RESULTS: A total of 94 patients were enrolled, with 47 in each study group. The mean BBPS for the whole colon in the SP group (8.15 ± 1.02) was higher than that in the PG group (7.55 ± 1.08; P = .007). Moreover, the segmental BBPS for the right side of the colon was significantly higher in the SP group (2.64 ± 0.48) than in the PG group (2.36 ± 0.60; P = .010). Adverse effects, such as nausea (31.9% vs 4.3%; P = .001), bloating (27.7% vs none; P < .0001), and disturbed sleep (63.8% vs 12.8%; P < .0001), were significantly more frequent in the PG group than in the SP group. CONCLUSIONS: The traditional yogic technique of shankha prakshalana is an effective method for bowel preparation in colonoscopy, with overall better efficacy and safety, compared with the standard split-dose PG regimen. (Clinical trial registration number: CTRI/2020/07/026899.).