Endoscopy 2025; 57(S 02): S592
DOI: 10.1055/s-0045-1806553
Abstracts | ESGE Days 2025
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“Efficacy and safety of Shankhaprakshalana, a yogic Technique versus Polyethylene Glycol for bowel preparation in colonoscopy:A non-inferiority Randomized controlled trial.”

Authors

  • M Chaudhary

    1   All India Institute of Medical Sciences, sijua, Patrapada, Bhubaneswar, Odhisha, India, Bhubaneswar, India

  • M Panigrahi

    2   All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odhisha, India, Bhubaneswar, Odisha, India, India

  • S Gupta

    3   AIIMS Bhubaneswar, Bhubaneswar, India

  • H Nayak

    3   AIIMS Bhubaneswar, Bhubaneswar, India
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Aims Shankhaprakshalana (SP) is a yogic technique, well known to cleanse the bowel and validated our recent retrospective pilot study. Split dose polyethylene glycol although recommended by ASGE, does not meet criteria for ideal bowel preparation. We have compared the efficacy and safety of Shankhaprakshalana with split dose polyethylene glycol (PEG) in bowel preparation for colonoscopy [1].

Methods Patients undergoing elective colonoscopy were randomized into two groups: PEG group (n=125) and SP group (n=125). Patients in the PEG group were given 2 liters of PEG 3350 in a split-dose regimen. Patients in the SP group were administered 400 ml of lukewarm saline water followed by a set of five asanas of SP with each asana performed eight times under supervision. This constituted one cycle, which was repeated six times (total intake of 2400 ml). Boston bowel preparation score (BBPS) was used to assess efficacy of bowel preparation and safety was assessed by adverse effects and lab evaluation. Tolerability and acceptability were also assessed by using pre-validated questionnaire.

Results The mean BBPS score for the whole colon in the SP group (8.49±0.85) was more than that in the PEG group (7.54±1.07) with a mean difference of 0.94 (95% CI 0.70 to 1.19 p<0.001) proving non – inferiority, hence favoring Shankhaprakshalana over PEG. Adverse effects such as nausea (35.9% vs 7.3%, p=0.002), bloating (27.7% vs none, p<0.0001), and disturbed sleep (63.8% vs 12.8%, p<0.0001) were significantly higher in the PEG group.

Conclusions The traditional yogic technique of “ShankhaPrakshalana” is non -inferior to the split dose PEG preparation for bowel preparation in colonoscopy in terms of efficacy and safety.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

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  • References

  • 1 Panigrahi MK, Prakash JH, Chouhan MI, Anirvan P, Chaudhary M, Gupta S, Nayak HK, R U AG, Manik R, Rath MM. Effectiveness and safety of Shankhaprakshalana-a yogic technique-in bowel preparation for colonoscopy: A retrospective study: Indian J Gastroenterol. 2023
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