|Year : 2019 | Volume
| Issue : 1 | Page : 26-30
Effect of yogic colon cleansing (laghu sankhaprakshalana kriya) on bowel health in normal individuals
Shashi Kiran1, Sunil Sapkota1, Prashanth Shetty2, Thittamaranahalli Muguregowda Honnegowda3
1 Department of Yoga, SDM College of Naturopathy and Yogic Sciences, Dakshina Kannada, Karnataka, India
2 Department of Natural Therapeutics, SDM College of Naturopathy and Yogic Sciences, Dakshina Kannada, Karnataka, India
3 Centre of Excellence, Government of India, SDM College of Naturopathy and Yogic Sciences, Dakshina Kannada, Karnataka, India
|Date of Web Publication||13-Jun-2019|
Thittamaranahalli Muguregowda Honnegowda
Centre of Excellence, Government of India, SDM College of Naturopathy and Yogic Sciences, Ujire, Dakshina Kannada, Karnataka
Introduction: Laghu sankhaprakshalana (LSP) is a type of yogic cleansing technique (Shatkarma) which is being practiced since ancient time. In this technique, set of Asanas that aid the intestinal motility are practiced along with intake of lukewarm saline water. It is an easy and effective technique to clean the gastrointestinal canal. This study aims to study the effect of LSP on bowel health.
Aim and Objectives: The main objective of this study is to evaluate the effect of LSP practice on bowel health in normal individuals and safety of it.
Materials and Methods: Sixty healthy individuals (males – 30 and females – 30) of the mean age 20.70 ± 2.89 were randomly recruited for study group (n = 30) and control group (n = 30). The study group was made to practice LSP once a week, for 4 weeks. The control group received no intervention. Constipation score (CS) was recorded by using the Cleveland Clinic CS, before and after completion of four sessions of LSP.
Results: There was a significant reduction in CS, p < 0.0001 after the four sessions of LSP practice.
Conclusion: The present study showed that LSP has a tendency to improve the bowel health. The practice of LSP once a week, for 4 weeks is safe and effective in a normal individual.
Keywords: Bowel health, constipation score, gastrointestinal tract, laghu sankhaprakshalana
|How to cite this article:|
Kiran S, Sapkota S, Shetty P, Honnegowda TM. Effect of yogic colon cleansing (laghu sankhaprakshalana kriya) on bowel health in normal individuals. Yoga Mimamsa 2019;51:26-30
|How to cite this URL:|
Kiran S, Sapkota S, Shetty P, Honnegowda TM. Effect of yogic colon cleansing (laghu sankhaprakshalana kriya) on bowel health in normal individuals. Yoga Mimamsa [serial online] 2019 [cited 2021 Jun 20];51:26-30. Available from: https://www.ym-kdham.in/text.asp?2019/51/1/26/260362
| Introduction|| |
Bowel health is associated with the healthy functioning of other systems like the cardiovascular system, nervous system, etc. The function of the gastrointestinal (GI) tract has been thought to have little impact on cardiovascular health. However, recently emerging evidence suggests that GI function may play a greater role in cardiovascular health (Agouridis, Elisaf & Milionis, 2011). Digestive diseases, such as inflammatory bowel disease and gallstone disease, have been associated with an increased risk of cardiovascular disease (CVD) (Andersen & Jess, 2014; Chang, Locke, Schleck, Zinsmeister & Talley, 2007; Digambarji & Gharote, 2000) as well as various cardiometabolic risk factors such as obesity, dyslipidemia, and insulin resistance (Everhart, Go, Johannes, Fitzsimmons, Roth & White, 1989). In addition, disorders of GI system are closely related to abundance, type, and metabolism of gut microbiota (Guo et al., 2014; Haldavnekar, Tekur, Nagarathna & Nagendra, 2014; Kim et al., 2015) with known impact on risk of CVD, diabetes, and other diseases (Leo et al., 2018; Lv et al., 2015; Maleki et al., 2000). Change in bowel movement frequency represents one of the major characteristics of functional bowel disorders (Muktibodhananda, 1998). One study shows that abnormal bowel movement frequency occurring in irritable bowel syndrome, and functional constipation has been related to a variety of cardiovascular risk factors, including elevated circulating levels of cholesterol and triglycerides, hypertension, and diabetes (Oh et al., 2009; Olaiya, Chiou, Jeng, Lien & Hsieh, 2013; Petrovitch et al., 2009; Ponnusamy, Choi, Kim, Lee & Lee, 2011; Qin et al., 2012; Rogler & Rosano, 2014). Another study shows that constipation is associated with low substantia nigra neuron density independent of the presence of Lewy Body (Salmoirago-Blotcher, Crawford, Jackson, Ockene & Ockene, 2011.
Sankhaprakhsālana is a yogic practice (kriya) recommended for cleansing the GI tract (Saraswati, 2013). Laghu Sankhaprakshālana (LSP) is a simple form of Sankhaprakhsālana kriya which is completed in a shorter time and offers lesser physical strain. The Sanskrit word laghu means “short, ”sankha means “shell, ”and prakshalana means “to wash. ”The word sankha is intended to represent and describe the intestine, with its cavernous and coiled shape. Therefore, the combined term sankhaprakshalana means to completely wash or clean the intestines. LSP is a more comprehensive technique which can be done very quickly and with little preparation. Furthermore, the two practices have a slightly different purpose: sankhaprakshalan cleans the whole GI tract, whereas LSP encourages normal functioning of the intestine. Lukewarm saline water creates a high osmotic pressure than pure water, preventing absorption. It also acts as a lubricant and loosens up the stool to flush the system. Normally, bulk and movement of stool that acts as a trigger which, in turn, stimulates the nerves which activate peristalsis. The lukewarm saline water softens the hardened stool to move, which prompts the nerve to carry out their normal functions of the GI tract (Singh, Jaiswal & Maurya, 1988). LSP clears the bowel by the activation of local peristaltic reflex during the various set of physical postures and strengthens the whole body (Saraswati, 2013; Talley, 2008). It is an easy and effective technique to clean the GI canal, thereby eliminating all the waste material and auto-intoxicants present in the intestine for a long time period. Clinical experience is evident of LSP being very effective for increasing body mass index (BMI), spinal flexibility and to reduce pain, disability, anxiety, and neurosis (Tang & Hazen, 2014; Tiwari & Roy, 2013). So far, there is no study to look at the effect of yogic cleansing techniques (LSP) on bowel health. Hence, the present study was planned with the objective to assess the impact of LSP on bowel health, the safety of its practice, and to correlate its use in clinical practice.
| Materials and Methods|| |
Sixty students, males (n = 30) and females (n = 30), aged between 18 and 24 years (20.70 ± 2.89) were recruited from the college in Dakshina Kannada for the study. The inclusion criteria: age group 18–24 years, no orthopedic limitations, healthy individuals, not having any medical condition, and willingness to participate voluntarily. The exclusion criteria: participants having any medical condition and individuals having a systemic illness, weak, and debilitating individuals. Written informed consent was obtained from the participants after explaining them the detailed procedure. The ethical clearance was obtained from the Ethical Committee of SDM College of Naturopathy and Yogic Sciences, Ujire.
Sixty students were randomly assigned to two groups, study group (n = 30) and control group (n = 30) using the online random number generating tool at the website – www.random.org [Figure 1]. The study group included healthy individuals of average age 20.70 ± 2.89 years and average BMI 26.93 ± 3.24 kg/m2. The control groups included healthy individuals of average age 20.70 ± 2.39 years and average BMI 27.26 ± 2.46 kg/m2. All the participants of both the group successfully completed the study. The study group underwent LSP once a week for 4 weeks. The control group did not receive any intervention.
The study group underwent the following procedure for LSP, early morning on an empty stomach. The participant was made to drink two glasses of lukewarm saline water as quickly as possible. They were instructed five Asanas ten times each in the following sequence: (1) Tadasana (Palm Tree Pose), (2) Tiryaka Tadasana (Swaying Palm Tree pose), (3) Kati Chakrasana (Waist Rotating Pose), (4) Tiryaka Bhujangasana (Twisting Cobra Pose), and (5) Udarakarshanasana (Abdominal stretch pose). This completed the first round of practice. After the completion of the first round, once again participants were asked to drink two more glasses of saline lukewarm water and again repeat the five Asanas ten times each. Participants completed the process by the maximum six to eight glass water. The individual was permitted to go to the toilet when the pressure built up. There was no rest during the asana and between the rounds. Total rest was provided to the individuals after the completion of the procedure by making them lie down in Shavasana for 5 min (Wu et al., 2013). After completing LSP, individual ate khicheri (cooked rice and lentil) with ghee. There was no any intervention for the control group participants and they were instructed to carry out their normal routine activities.
The entire participants were assessed before the intervention, as to take pre- and post-data were taken after 24 h of last intervention. Constipation score (CS) was measured by using Cleveland Clinic CS. The Constipation Scoring System (CSS), a commonly used scoring system, is designed to assess the prevalence and severity of constipation. It is based on the pathophysiological definition of constipation. The scoring system is based on eight variables. (frequency of bowel movements, difficult or painful evacuation, completeness of evacuation, abdominal pain, time per attempt, type of assistance including laxatives, digitations or enemas, number of unsuccessful attempts at evacuation in a 24-h period, and duration of constipation). The CSS consists of seven items that are scored using a five-point Likert scale that ranges from 0 (none of the time) to 4 (all of the time) and one item that is rated on a 0–2 scale. A total score can range from 0 (normal) to 30 (severe constipation). A cutoff score of 15 suggests constipation.
The statistical analysis of data within the group was performed using paired-t-test and between the group, analysis was performed using independent samples t-test with the use of SPSS version 20 (SPSS Inc., Chicago, IL, USA). p < 0.05 was considered as statistically significant.
| Results|| |
The recruited 60 participants were randomized into two groups, study group (n = 30) and control group (n = 30). Baseline and postintervention assessment of each group were taken before and after the intervention. To compare baseline and postintervention assessment between the group independent samples t-test was performed and to compare within the group paired samples t-test was performed. There were no significant differences in demographic variables of the participants of both the groups [Table 1].
|Table 1: Demographic variables of study group (n=30) and control group (n=30)|
Click here to view
Statistical analysis was done to compare baseline and postintervention assessments of between the groups (independent samples t-test) and within the group (dependent t-test). There was no significant difference between case and control group at baseline assessment [Table 2]. The result of our study showed that there was a statistically significant difference between the case and control group of postintervention assessment [Table 3]. The analysis within the group done using the dependent t-test showed the significant decrease in CS, p < 0.001 [Table 4].
|Table 2: Baseline assessment of the study group (n=30) and control group (n=30) by independent t-test|
Click here to view
|Table 3: Postassessment of the study group (n=30) and control group (n=30) by dependent t-test|
Click here to view
|Table 4: Baseline assessment and postassessment of the study group (n=30) and control group (n=30) by dependent t-test|
Click here to view
| Discussion|| |
The present study assessed the effect of yogic colon cleansing technique (LSP) on bowel health in the healthy individual. This study examined the changes in CS after the practice of LSP. The finding suggested that, there is a decrease in CS (p < 0.001) in the study group but no changes in the control group. There is no adverse effect of LSP documented which suggested that it is safe to practice once in a week for 4 weeks by healthy individuals. Frequency of bowel movements, difficult or painful evacuation, completeness of evacuation, abdominal pain, time per attempt,; type of assistance including laxatives, digitations or enemas, number of unsuccessful attempts at evacuation in a 24-h period, and duration of constipation are the variables of CSS. The decrease in CS indicates that improves in bowel health.
The digestive tract requires being rotated in order to be washed thoroughly. In LSP, this is achieved by performing a set of Asanas which increase intestinal motility temporarily. Tadasana (Palm Tree Pose), opens the pyloric sphincter of the stomach through the expansion of esophagus, stomach, and duodenum. Then, saline water enters into the small intestine (Gherand Samhita, Chapter 1, and Verse 17). Tiryaka Tadasana (Swaying Palm Tree pose), repeatedly contracts in one side and relaxes in another side of the intestines (Gherand Samhita, Chapter 1, and Verse 17). Katichakrasana (Waist Rotating Pose) twists the whole smooth muscles of stomach and intestine, which pushes the foodstuffs downward along with the water (Gherand Samhita, Chapter 1, Verse 17). Tiryaka Bhujangasana (Twisting Cobra Pose) opens the ileocecal sphincter. At that moment from the small intestine, water enters into the large intestine (Gherand Samhita, Chapter 1, Verse 17). Udarakarshan (Abdominal stretch Pose) stretches the digestive organs, nerves, and muscles. Therefore, repeated contraction and relaxation occurs in the whole digestive tract (Gherand Samhita, Chapter 1, Verse 17). Finally, complete bowel evacuation occurs and the GI tract will be free from fecal matter (Talley, 2008). This cleansing of the GI tract improves the digestive process and bowel health.
The strengths of the study were: effective randomization and no adverse effects during the study. Limitations of the study: a smaller sample size, no blinding, and only subjective variables. Future studies may be designed to look at the long-term effect of LSP on bowel health.
| Conclusion|| |
The present study showed LSP has a tendency to improve the bowel health. Hence, this yogic practice can be suggested in cleansing modalities of Naturopathic and Yogic treatments on a regular basis. The practice of LSP once a week, for 4 weeks is safe and effective in a healthy individual. Large-scale randomized trials are warranted to confirm the results.
The authors acknowledge the Central Council for Research in Yoga and Naturopathy, Ministry of AYUSH, Government of India, New Delhi, for the financial support for the study and for their valuable suggestions and scientific inputs.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Agouridis, A. P., Elisaf, M., & Milionis, H. J. (2011). An overview of lipid abnormalities in patients with inflammatory bowel disease. Annals of Gastroenterology
Andersen, N. N., & Jess, T. (2014). Risk of cardiovascular disease in inflammatory bowel disease. World Journal of Gastrointestinal Pathophysiology
Chang, J. Y., Locke, G. R., Schleck, C. D., Zinsmeister, A. R., & Talley, N. J. (2007). Risk factors for chronic constipation and a possible role of analgesics. Neurogastroenterology & Motility
Digambarji, S., & Gharote, M. (2000). Gheranda samhita
ed.), (p. 38). Lonavla: Kaivalyadhama SMYM Samiti.
Everhart, J. E., Go, V. L., Johannes, R. S., Fitzsimmons, S. C., Roth, H. P., & White, L. R. (1989). A longitudinal survey of self-reported bowel habits in the United States. Digestive Diseases and Sciences, 34
Guo, Y., Niu, K., Momma, H., Kobayashi, Y., Chujo, M., & Otomo, A., … et al.
(2014). Irritable bowel syndrome is positively related to metabolic syndrome: A population-based cross-sectional study. PloS One
Haldavnekar, R. V., Tekur, P., Nagarathna, R., & Nagendra, H. R. (2014). Effect of yogic colon cleansing (Laghu Sankhaprakshalana Kriya) on pain, spinal flexibility, disability and state anxiety in chronic low back pain. International Journal of Yoga,
7 (2), 111-119.
Kim, S. E., Choi, S. C., Park, K. S., Park, M. I., Shin, J. E., & Lee, T. H., … et al.
(2015). Constipation Research group of Korean Society of Neurogastroenterology and Motility. Change of fecal flora and effectiveness of the short-term VSL#3 probiotic treatment in patients with functional constipation. Journal of Neurogastroenterology and Motility
Leo C. A., Campennì, P., Hodgkinson, J. D., Rossitti, P., Digito, F., & De Carli, G., … et al.
(2018). Long-term functional outcome after internal Delorme's procedure for obstructed defecation syndrome, and the role of postoperative rehabilitation. Journal of Investigative Surgery, 31
Lv, J., Qi, L., Yu, C., Guo, Y., Bian, Z., & Chen, Y., … et al.
China Kadoorie Biobank Collaborative Group. (2015). Gallstone disease and the risk of ischemic heart disease. Arteriosclerosis, Thrombosis, and Vascular Biology
Maleki, D., Locke, G. R. 3rd
, Camilleri, M., Zinsmeister, A. R., Yawn, B. P., & Leibson, C., … et al.
(2000). Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Archives of Internal Medicine
Muktibodhananda, S. (1998). Hatha yoga pradipika
ed.), (p. 125). Munger, Bihar, India: Yoga Publication Trust.
Oh, J. H., Choi, M. G., Kang, M. I., Lee, K. M., Kim, J. I., & Kim, B. W., … et al.
(2009). The prevalence of gastrointestinal symptoms in patients with non-insulin dependent diabetes mellitus. The Korean Journal of Internal Medicine
Olaiya, M. T., Chiou, H. Y., Jeng, J. S., Lien, L. M., & Hsieh, F. I. (2013). Significantly increased risk of cardiovascular disease among patients with gallstone disease: A population-based cohort study. PloS one
Petrovitch, H., Abbott, R. D., Ross, G. W., Nelson, J., Masaki, K. H., & Tanner, C. M., … et al.
(2009). Bowel movement frequency in late-life and substantia Nigra neuron density at death. Movement Disorders: Official Journal of the Movement Disorder Society, 24
Ponnusamy, K., Choi, J. N., Kim, J., Lee, S. Y., & Lee, C. H. (2011). Microbial community and metabolomic comparison of irritable bowel syndrome faeces. Journal of Medical Microbiology
(Pt 6), 817-827.
Qin, J., Li, Y., Cai, Z., Li, S., Zhu, J., & Zhang, F., … et al.
(2012). A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature, 4
Rogler, G., & Rosano, G. (2014). The heart and the gut. European Heart Journal
Salmoirago-Blotcher, E., Crawford, S., Jackson, E., Ockene, J., & Ockene, I. (2011). Constipation and risk of cardiovascular disease among postmenopausal women. The American Journal of Medicine, 124
Saraswati, S. S. (2013). Textbook of A systematic course in the ancient tantric techniques of yoga & kriya
(2013 ed), (p. 139). Munger Bihar India: Yoga Publication Trust.
Singh, S. N., Jaiswal, V., & Maurya, S. P. (1988). “Shankha prakshalana ”(gastrointestinal lavage) in health and disease. Ancient Science of Life, 7
Talley, N. J. (2008). Functional gastrointestinal disorders as a public health problem. Neurogastroenterology & Motility, 20
Tang, W. H., & Hazen, S. L. (2014). The contributory role of gut microbiota in cardiovascular disease. The Journal of Clinical Investigation
Tiwari, S. P., & Roy, D. (2013). A study on the effect of Shatkarma on body weight in the patients of diabetes mellitus. Trends in Life Sciences
Wu, T., Zhang, Z., Liu, B., Hou, D., Liang, Y., Zhang, J., & Shi, P. (2013). Gut microbiota dysbiosis and bacterial community assembly associated with cholesterol gallstones in large-scale study. BMC Genomics
Sharma, S., & Agarwal, B. B. (2012). Scoring systems in evaluation of constipation and oebstructed defecation syndrome (ODS). JIMSA, 25
[Table 1], [Table 2], [Table 3], [Table 4]