P2397 - Step by Step: A Meta-Analysis and Systematic Review on the Impact of Walking on Colonoscopy Outcomes

Islam Mohamed, MD¹, Hazem Abosheaishaa, MD², Sarah George, ¹, Khushi Parekh, ¹, Nina Henry, BS³, Suman Manek, ¹, Lauren K. Baetje, ¹, Mira Bhatia, ¹, Noor Hassan, MD⁴, Fouad Jaber, MD¹, Syed Hamaad Rahman, DO⁵, Maya Mahmoud, MD⁶, Yazan Abboud, MD⁷, Dushyant S. Dahiya, MD⁸, Yusuke Hashimoto, MD^9
1University of Missouri - Kansas City School of Medicine, Kansas City, MO; ²Icahn School of Medicine at Mount Sinai, Queens, NY; ³University of Missouri - Kansas City School of Medicine, St. Joseph, MO; ⁴University of Missouri Kansas City School of Medicine, Kansas City, MO; ⁵Methodist Dallas Medical Center, Irving, TX; ⁶SSM Health Saint Louis University Hospital, St. Louis, MO; ⁷Rutgers New Jersey Medical School, Newark, NJ; ⁸The University of Kansas School of Medicine, Kansas City, KS; ⁹University of Florida College of Medicine, Jacksonville, FL

Introduction: Colorectal cancer remains a significant global health challenge, with effective screening relies on the success of bowel preparation before a colonoscopy. Inadequate prep affects lesion detection and increases procedural risks. Traditional prep methods are often poorly tolerated by patients, highlighting the need for improved strategies. Recent evidence suggests that walking may enhance bowel prep quality by stimulating gastrointestinal mobility. This systematic review and meta-analysis aims to evaluate the effectiveness and safety of incorporating walking exercise into bowel preparation before colonoscopy.

Methods: Our systematic review and meta-analysis encompassed four major databases: Embase, Medline, Cochrane, and Scopus, assessing walking's efficacy in bowel preparation for colonoscopy. Utilizing Covidence, search results underwent screening based on predefined PICO criteria for inclusion/exclusion. Four eligible randomized controlled trials were identified. Data extraction involved general study characteristics, baseline patient characteristics, and outcome measures, performed by four independent reviewers. Risk of Bias evaluation employed the RoB 2 tool for RCTs. Statistical analysis utilized RevMan v5.3, employing mean differences and random-effects models. Statistical significance was indicated by a p-value of less than 0.05. Heterogeneity was assessed with I-square tests.

Results: Our meta-analysis included four RCTs with a total of 1218 patients. We found that walking exercise did not yield a significant difference in total Boston Bowel Preparation Scale (BPPS) score compared to control groups. However, walking exercise led to statistically significant improvements in ascending colon BPPS score, transverse colon BPPS score and descending colon BPPS score. However, walking exercise did not significantly affect cecal intubation time or total procedure time. While there was no significant difference in the time to first diarrhea, the total number of diarrheal episodes was significantly impacted by walking exercise.

Discussion: In conclusion, while walking exercise did not significantly affect total BPPS scores, procedural timelines, or cecal intubation times, it demonstrated significant improvements in the individual colon segment BPPS scores and instances of diarrhea. These findings suggest that walking may have a beneficial effect on specific aspects of bowel preparation for colonoscopy, highlighting its potential as an adjunctive strategy in enhancing colonoscopy outcomes.



Disclosures:


Islam Mohamed, MD¹, Hazem Abosheaishaa, MD², Sarah George, ¹, Khushi Parekh, ¹, Nina Henry, BS³, Suman Manek, ¹, Lauren K. Baetje, ¹, Mira Bhatia, ¹, Noor Hassan, MD⁴, Fouad Jaber, MD¹, Syed Hamaad Rahman, DO⁵, Maya Mahmoud, MD⁶, Yazan Abboud, MD⁷, Dushyant S. Dahiya, MD⁸, Yusuke Hashimoto, MD⁹. P2397 - Step by Step: A Meta-Analysis and Systematic Review on the Impact of Walking on Colonoscopy Outcomes, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.