Yoga and Bolus Lukewarm Saline as Rapid Colonoscopy Preparation
Condition: Colonic Neoplasms
MeSH terms: Colonic Neoplasms
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      A quality colonoscopy examination remains as the gold standard for colorectal cancer
      screening, but effective large bowel cleansing prior to colonoscopy is still not achieved in
      all cases that undergo the procedure. Currently, the most widely used cleansing methods
      employ balanced electrolyte-polyethylene glycol (PEG) solutions. However, a very large volume
      of PEG solution is required for it to be effective, and many patients refuse to drink a
      sufficient amount due to non-palatability. In this study, the investigators compare a novel
      colon preparation method--bolus lukewarm saline with yoga exercise--with a PEG based solution
      (HalfLytely) for large bowel cleansing.
    

Detailed description: 
      Effective large bowel cleansing prior to colonoscopy is still not achieved in all cases that
      undergo the procedure. The use of balanced electrolyte-polyethylene glycol (PEG) solution
      have improved the cleansing results and shortened the time needed for preparing the bowel.
      The problem with using PEG solution alone is the relatively large volume of the solution that
      the patients need to drink. The recommendation is to drink the solution until diarrhea fluid
      is clear and often 4 L or more is needed. Many patients refuse to drink the sufficient volume
      needed to get a clean colon due to non-palatability. Good results of bowel cleansing have
      also been reported with sodium phosphate solution or tablets.

      The fluid volume needed to drink along with sodium phosphate is generally no problem but this
      regimen causes electrolyte disturbances and renal insufficiency that usually are subclinical
      and of no significance. Several combinations of PEG solution and laxatives have been tested
      before. Low-volume PEG plus Bisacodyl preparation was better tolerated but it was not as
      effective as standard large-volume PEG and associated with abdominal cramping.

      PEG solution 2L and Bisacodyl is used for large bowel cleansing in many centers in the United
      States and is the standard regimen used in our colonoscopy unit. In this study the
      investigators compare this standard regimen taken day before colonoscopy with Bolus lukewarm
      saline solution taken orally with yoga exercise on the day of colonoscopy.

      The result of large bowel cleansing is evaluated during the colonoscopy according to a
      validated scoring method. Time to the first bowel movement and total preparation time are
      compared. Solution palatability, patient acceptability, abdominal symptoms, discomfort and
      subjective grading of how hard/easy it was to complete the cleansing program are evaluated
      with questionnaires.
    

Intervention name(s): Normal (0.9%) saline; HalfLytely
Intervention type(s): Drug; Drug
Intervention description(s): A total of 2L solution at lukewarm temperature (37.2-38.8 degrees Centigrade)consumed as bolus intake (8-16 oz in one to two minutes) alternating with yoga exercises.; A total of 2L solution prepared as per manufacturers instructions and sipped until bowel movements are clear.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Colonoscopy; Yoga; Complementary and alternative medicine; Bowel cleansing; Large bowel preparation; Cancer screening; Colorectal cancer