P3403 - Laghu Shankha Prakshalana, a Yogic Technique as a Rescue in Patients Having Inadequate Bowel Preparation With Standard Regimen : A Prospective Cohort Study

Mansi Chaudhary, MBBS, MD¹, Manas Kumar Panigrahi, MBBS, MD, DM¹, Prajna Anirvan, MBBS, MD, DM², Jain Harsh Prakash, MBBS, MD¹, Shubham Gupta, MBBS, MD¹, Abhijeet Rai, MBBS, MD¹, Hemanta Kumar Nayak, MBBS, MD, DM¹, Ajay Ghosh, BSc, MSc¹, Subash Chandra Samal, MBBS, MD, DM¹, Biswa Mohan Padhy, MBBS, MD, DM^1
1AIIMS, Bhubaneswar, Orissa, India; ²All India Institute of Medical Sciences, Bhubaneswae, Orissa, India

Introduction: Colonoscopy is the gold standard test for evaluation of colonic mucosa. Split dose Polyethylene glycol (PEG) solution is one of the most commonly recommended bowel preparation agent for colonoscopy. Inadequate bowel cleansing is independently associated with the increased risk of both polyps and adenomas being missed during the colonoscopy procedure and leads to delay in diagnosis and increases cost of repeating the procedure. The traditional yogic technique of “Laghu Shankha Prakshalana” (LSP) has been known to clean bowel, a pilot study has been conducted by our group to assess the efficacy of Laghu Shankha Prakshalana in bowel preparation. The aim of this study was to establish role of LSP as rescue bowel preparation in patients who have inadequate bowel preparation after split dose polyethylene glycol solution.

Methods: This was a prospective cohort study done in a tertiary care centre in India in which all patients undergoing colonoscopy on OPD basis were screened for inclusion in the study. Patients whose BBPS score were less than 6 and gave the consent were subjected to repeat colonoscopy after performing Laghu Shankha Prakshalana on the same day. Patients were advised to drink 400 ml of lukewarm saline water followed by five asanas – Tadasana, Tiryakatadasana, Katichakrasana, Tiryakabhujangasana ,Udarakarshanasana of LSP, each done eight times, and the cycle was repeated three times. BBPS before and after LSP were calculated and used to assess efficacy of LSP.

Results: 200 patients underwent colonoscopy during the study period (march-april, 2023) out of which 40 (20%) patients had inadequate bowel preparation in form of BBPS < 6. Out of 40 patients, 25(62.5%) patients met the exclusion criteria.Fifteen (37.5%) patients underwent LSP and colonoscopy was repeated. Out of 15 patients, eleven (73.3%) patients had a BBPS of 9/9 and 2 (13.33%) patients had a score of 8/9 and 2 (13.33%) had score less than 6. Adequate bowel preparation has been achieved in 86.6% of patients. No severe adverse events were registered.

Discussion: Use of LSP as a rescue strategy after inadequate bowel preparation with PEG electrolyte solution appears to be an effective technique to achieve adequate bowel cleansing and likely reduce the cost of repeat colonoscopy.



Disclosures:


Mansi Chaudhary, MBBS, MD¹, Manas Kumar Panigrahi, MBBS, MD, DM¹, Prajna Anirvan, MBBS, MD, DM², Jain Harsh Prakash, MBBS, MD¹, Shubham Gupta, MBBS, MD¹, Abhijeet Rai, MBBS, MD¹, Hemanta Kumar Nayak, MBBS, MD, DM¹, Ajay Ghosh, BSc, MSc¹, Subash Chandra Samal, MBBS, MD, DM¹, Biswa Mohan Padhy, MBBS, MD, DM¹. P3403 - Laghu Shankha Prakshalana, a Yogic Technique as a Rescue in Patients Having Inadequate Bowel Preparation With Standard Regimen : A Prospective Cohort Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.