Yoga as an Alternative to Biofeedback in Patients with Solitary Rectal Ulcer Syndrome: A Pilot Study

Abstract Introduction: Solitary rectal ulcer syndrome (SRUS) is a rare disorder that may affect different areas of the rectum and other parts of the lower gastrointestinal tract. For the management of SRUS, a wide range of therapeutic interventions have been tried, from conservative management and behavioral therapy to surgery. The study aimed to ascertain the efficacy of yoga technique Koshta Shudhi Kriya (KSK) as a treatment for SRUS. Materials and Methods: This was a single-center, prospective study of patients at a tertiary care institute in India. After the initial screening, 11 patients were diagnosed with SRUS, and among them, eight patients were included in this study. Four participants were enrolled in the yogic therapy KSK arm, and four were in the standard medical treatment (SMT) arm. Participants were advised to drink 400 mL of lukewarm water, followed by six asanas (yogic postures) of KSK, and each asana was performed eight times simultaneously in a dynamic manner without any break in between. This constitutes one cycle. Participants are advised to do three cycles at a time. They have advised doing the same three cycles every day at home for 4 weeks. The study focused on the efficacy of yoga technique, KSK, as a biofeedback approach as the primary outcome and the characteristics of bowel elimination habits as the secondary outcome. Results: The median age range of the KSK and SMT group participants is 53.5 (51, 59) years and 48.5 (31.25 and 51.50) years, respectively. The symptoms, such as blood in stool (50%–0), pain on defecation (25%–0), and the sensation of incomplete bowel evacuation (50%–0), resolved fully in the Yoga (KSK) group after 4 weeks. The bowel elimination habits also improved in the yoga (KSK) group, as nobody reported constipation and finger evacuation, and reduced the time spent in the toilet. Conclusion: This pilot study suggests a potential benefit for yoga (KSK) in SRUS. Larger studies contrasting the yoga-based strategy with conventional SRUS therapy modalities are required to determine the effectiveness of this innovative biofeedback technique.