When you have your colonoscopy done may have an impact on how effective it is, a new study suggests.
Dr. Brennan Spiegel and his colleagues at the University of California-Los Angeles, and the VA Greater Los Angeles Healthcare System tested whether time of day affected how many polyps were found and removed during a colonoscopy, a test that examines the large intestine to spot these potentially precancerous growths.
The researchers followed 477 patients at a large VA hospital in Los Angeles. In early-morning cases - those started by 8:30 a.m. - doctors found 27 percent more polyps than in later cases. Hour by hour, the number of polyps fell as the day went on.
Patients prepare by drinking colon-cleansing solutions the night before so that any polyps will be more visible. The authors said that early patients’ colons might be cleaner, but that their analysis suggests this couldn’t completely explain the difference in the number of polyps found.
The researchers speculated that repetition of the same procedure might lead to cognitive errors by doctors later in the day.
BOTTOM LINE: More polyps were found in patients having colonoscopies earlier rather than later in the day.
CAUTIONS: While the difference in the number of polyps found in early and later cases was statistically significant, the difference was small - less than one-quarter of one polyp per patient.
WHERE TO FIND IT: Clinical Gastroenterology and Hepatology, November
Yoga for back pain
A small study to test yoga as a way to relieve back pain in minority patients suggests it might be more effective than usual care.Dr. Robert Saper of Boston University School of Medicine led a team that recruited people with chronic lower back pain at two community health centers in Boston. Most of the 30 participants were members of a racial or ethnic minority group and almost half were poor, a population that has been less likely than other demographic groups to try yoga. Fifteen patients were randomly enrolled in hatha yoga classes and 15 were assigned to usual care for back pain, including doctor’s visits and pain medications, while they waited to take the yoga classes.
The yoga group came to weekly classes that included relaxation, posture, and breathing exercises. Home practice for 30 minutes a day was encouraged and participants received training CDs, a CD player, a handbook, and a yoga mat, strap, and block. All participants were asked to report on their back pain, whether it limited their daily activities, and whether they took pain medications.
After 12 weeks, the people who took yoga were more likely than people getting the usual care to say their pain decreased. Among yoga participants, pain medication use fell from 63 percent to 13 percent, while there was no change in the usual-care group. Three-quarters of the yoga participants said they improved overall, compared with a quarter of people in the usual-care group.
BOTTOM LINE: Yoga classes for people in racially diverse communities may be an effective way to treat chronic lower back pain.
CAUTIONS: The study was small, and after 26 weeks, the number of people still participating in the yoga program fell from 14 to 8, raising questions about retention.
WHAT’S NEXT: A larger study will test yoga over a longer time period.
WHERE TO FIND IT: Alternative Therapies in Health and Medicine, November
ELIZABETH COONEY 
