Walking exercise improves bowel prep for colonoscopy
Last Updated: September 27, 2005



NEW YORK (Reuters Health) - Adding walking exercise to the bowel
cleansing procedure results in better colonic cleansing without
increasing patient discomfort and should be recommended as part of
routine colonoscopic bowel preparation in ambulatory outpatients,
physicians in South Korea report.


"Adequate bowel preparation is one of the most difficult aspects of
colonoscopy," Dr. Hyun Soo Kim and colleagues note in their report in
the American Journal of Gastroenterology for September 5. A key
barrier to successful colonoscopy is inadequate bowel cleansing, with
poor preparation increasing the risk of missed lesions, complications
and a prolonged procedure time.

Based on animal studies showing that exercise improved defecation,
Dr. Kim, from Yonsei University Wonju College of Medicine in Seoul,
and colleagues theorized that walking exercise would improve colonic
cleansing.

For their prospective study, they randomly assigned patients to
walking exercise (n = 182) or to a nonexercise group (n = 174), with
both groups drinking 2.5 to 3 L of polyethylene glycol solution (PEG).

Those randomized to the walking exercise group were instructed to
drink 250 mL of PEG and then walk at least 5 minutes at intervals of
10 minutes until they had finished consuming the PEG. Those in the
nonexercise group drank 250 mL of PEG every 10 minutes, resting in
between.

Significantly more patients in the exercise group had excellent or
good preparations (40.7% versus 25.3% in the nonexercise group.
Multivariate analysis also showed that walking improved the
proportion of satisfactory colonic cleansing (odds ratio 2.06; p =
0.003), regardless of the presence of constipation.

Subgroup analysis showed walking to be of additional benefit in
patients younger than 65 years old and in patients without obesity or
a past history of abdominal or gynecologic surgery. Therefore, the
authors advise, "walking exercise for colonoscopic bowel preparation
should be recommended primarily for younger nonobese ambulatory
patients without a history of abdominal or gynecological surgery."





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