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Effectiveness and safety of Shankhaprakshalana—a yogic technique—in bowel preparation for colonoscopy: A retrospective study

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Introduction

Shankhaprakshalana (SP) is a yogic method aiming to cleanse the bowel. It involves the use of warm saline water and a combination of five asanas. This study was designed to assess the effectiveness and safety of bowel preparation by SP.

Methods

This is a retrospective observational study of prospectively collected data. Patients planned for colonoscopy were screened and enrolled to undergo bowel preparation by SP on the day of the colonoscopy. Patients having comorbid conditions, poor performance status, suspected or previously diagnosed intestinal stricture and past history of major abdominal surgery and those unable to perform asanas of SP were excluded. A low-fiber diet was advised for one day before the colonoscopy. Patients were advised to drink 400 mL of lukewarm saline water followed by five asanas (exercises) of SP, each done eight times dynamically and sequentially. After completing six such cycles, patients underwent colonoscopy. Boston Bowel Preparation Scale (BBPS) score was used to assess the quality of bowel preparation.

Results

Total 238 patients were included. The major indications for colonoscopy were abdominal pain (35.3%), hematochezia (23.9%), diarrhea (20.2%), constipation (10.9%) and anemia (9.7%). The mean age was 37.7 (± 12) years. The mean BBPS was 8 (± 1.2). Bowel preparation was inadequate (BBPS < 6) in only two patients. Mean segmental BBPS for the three segments of the colon (right, transverse and left) was 2.6 (± 0.5), 2.7 (± 0.4) and 2.6 (± 0.7), respectively. Minor adverse events (nausea, abdominal pain, vomiting, giddiness and bloating) were noted in 10 participants (4.2%), which did not require hospitalization. Bowel preparation was completed in 133 (± 35) minutes.

Conclusion

Shankhaprakshalana is an effective and safe method to achieve adequate bowel preparation before colonoscopy. Since this is a single-center and retrospective study, future multi-centric, prospective studies comparing it with the standard bowel preparation regimens are warranted.

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Author information

Authors and Affiliations

  1. Department of Gastroenterology, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, 751 019, India

    Manas Kumar Panigrahi, Jain Harsh Prakash, Mohd Imran Chouhan, Prajna Anirvan, Mansi Chaudhary, Shubham Gupta, Hemanta Kumar Nayak, Ajaya Ghosh R. U. & Rajesh Manik

  2. Department of Medicine, Government Medical College, Rajouri, Jammu and Kashmir, 185 131, India

    Mohd Imran Chouhan

  3. Department of Yoga, Kalinga University, Nava Raipur, 492 101, India

    Rajesh Manik

  4. Department of Pathology, Hi-Tech Medical College and Hospital, Bhubaneswar, 751 010, India

    Mitali Madhumita Rath

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  1. Manas Kumar Panigrahi
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Contributions

MKP conceptualized, designed, wrote and edited the final version of manuscript. JHP collected the data and wrote the first draft and has done the statistical part of the manuscript. MIC designed the study, collected the data and edited the draft. PA reviewed the colonoscopy and edited the manuscript. MC and SG were involved in data collection. HKN has done the colonoscopy. AGRU has coordinated the study. RM has supervised the yoga. MMR conceptualized, designed and edited the manuscript. All authors approve final version of manuscript.

Corresponding author

Correspondence to Manas Kumar Panigrahi.

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Conflict of interest

MKP, JHP, MIC, PA, MC, SG, HKN, AGRU, RM, MMR declare no competing interests.

Ethics statement

The study was performed conforming to the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Written informed consent was obtained from all participating patients.

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The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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Panigrahi, M.K., Prakash, J.H., Chouhan, M.I. et al. Effectiveness and safety of Shankhaprakshalana—a yogic technique—in bowel preparation for colonoscopy: A retrospective study. Indian J Gastroenterol (2023). https://doi.org/10.1007/s12664-023-01488-9

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