CC BY 4.0 · Journal of Digestive Endoscopy 2024; 15(01): 059-104
DOI: 10.1055/s-0044-1786331
Abstracts of presentation during ENDOCON 2024, New Delhi

Yogic Technique of “Laghu Shankhaprakshalana’’: A Feasible and Cost-Effective Method for Rescue after Inadequate Standard Bowel Preparation with Polyethylene Glycol—A Prospective Interventional Study

Manas Kumar Panigrahi
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Shubham Gupta
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Mitali Madhumita Rath
2   Department of Pathology, IMS, and SUM Hospital -II, Phulnakhara, Bhubaneswar, Odisha, India
,
Jain Harsh Prakash
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Prajna Anirvan
3   Kalinga Gastroenterology Foundation, Cuttack, Odisha, India
,
Mansi Chaudhary
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Hemanta Kumar Nayak
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
,
Ajay Ghosh RU
1   Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
› Author Affiliations
› Further Information
 

Introduction: Inadequate bowel preparation is reported in 5 to 30% of all colonoscopies.1 It is associated with increased procedure time, incomplete procedure, missed lesions, increased risk of complications, and rescheduling.2 This results in increased direct and indirect costs for the patients as well as an increased burden on the healthcare system.

Recently Panigrahi et al have shown that the yogic technique of Shankhaprakshalana (SP) can be used for bowel preparation.3 Laghu Shankhaprakshalana (LSP) is an abbreviated version of SP. We hypothesized that if bowel preparation is inadequate after use of polyethylene glycol (PEG), LSP can be used for the rescue on the same day to have an adequate bowel preparation. Our primary objective was to assess the feasibility and cost-effectiveness of rescue LSP in patients with inadequate bowel preparation after taking split-dose PEG.

Methods: It is a single-center prospective study conducted at AIIMS Bhubaneswar between April 2023 to October 2023. Patients >18 years of age having inadequate bowel preparation (Total Boston Bowel Preparation Score < 6 or segmental score < 2) were included. Patients having severe comorbidities, poor performance status, admitted patients and refusing to give consent were excluded. Eligible patients were asked to choose between same-day colonoscopy after LSP or repeat colonoscopy with split dose PEG.

Results: Total 114 of 844 patients had inadequate bowel preparation. After satisfying inclusion criteria 81 patients were enrolled. Fifty patients opted for repeat PEG and 31 patients opted for LSP as a rescue. The baseline demographic was similar in both groups. Results comparing LSP and repeat PEG are shown in Table 1.

Discussion and Conclusion: In patients with inadequate bowel preparation after standard split-dose PEG, same-day colonoscopy with LSP is more effective in terms of bowel preparation, easy on pocket to patients, and reduces extra burden on healthcare system.



Publication History

Article published online:
22 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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