Abstract
Our purpose was to observe the effects of sodium phosphate (NaP) colonoscopy preparation on serum electrolytes, phosphate, and calcium and to identify factors associated with any adverse effects. In an unselected group of 100 consecutive patients attending for out patient colonoscopy, 45% of patients had raised serum phosphate, which was positively correlated with creatinine and age. There was a negative association of phosphate with calcium; 16% of patients had hypocalcemia and 26% had hypokalemia. Patients taking ACE inhibitors, AT2 antagonists, or diuretics were associated with hyperphosphatemia. Significant electrolyte and metabolic disturbance from colonoscopy preparation has been shown with NaP preparation, without overt clinical effects. We recommend that elderly patients and those with significant comorbidity have their electrolytes and calcium measured, and diuretics and ACE inhibitors stopped, before NaP administration. Endoscopy units should be alert for patients who might be suffering from electrolyte disturbance postpreparation and be prepared to measure their electrolytes.
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References
Laxatives for bowel clearing before colonoscopy. Drugs Ther Bull 40(11):86–88, 2002
Safety of Sodium Phosphates oral solution. US Food and Drug Administration, Center for Drug Evaluation and Research 9;2001. http://www.fda.gov/cder/safety/sodiumphospate
Campisi P, Badhwar V, Morin S, Trudel JL: Postoperative hypocalemic tetany caused by fleet phospho-soda preparation in a patient taking alendronate sodium. Dis Colon Rectum 42(11):1499–1501, 1999
Tan Hl, Liew QY, Loo S, Hawkins R: Severe hyperphosphatemia and associated electrolyte and metabolic derangement following the administration of NaP for bowel preparation. Anaesthesia 57(12):1236, 2002
Ullah N, Yeh R, Ehrinpries M: Fatal hyperphosphatemia from a phosphosoda bowel preparation. J Clin Gastroenterol 34(4):457–458, 2002
Tan HL, Liew QY, Loo S, Hawkins R: Severe hyperphosphatemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia 57:478–483, 2002
Lieberman DA, Ghormley J, Flora K: Effect of oral NaP colon preparation on serum electrolytes in patients with normal serum creatinine. Gastrointest Endosc 43(5):524–528, 1996
Beloosesky Y, Grinblat J, Weiss A, Grosman B, Gafter U, Chagnac A: Electrolyte disorders following oral nap administration for bowel cleansing in elderly patients. Arch Intern Med 163:803–808, 2003
Ayus CJ, Levine R, Arieff AI: Fatal dysnatremia caused by elective colonoscopy. BMJ 326:382–384, 2003
Seinela L, Pehkonen E, Laasanen T, Ahvenianen: Bowel preparation for colonoscopy in very old patients. Scand J Gastroenterol 38(2):216–220, 2003
Poon CM, Lee DW, Mak SK, Ko CW, Can KC, Chan KW, Sin KS Chan AC: Two litres of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy. Endoscopy 34(7):560–563, 2002
Ell C, Fischbach W, Keller R, Dehe M, Mayer G, Schneider B, Albrecht U, Schuette W: A randomised prospective trial to compare the safety and efficacy of three bowel-cleansing solutions for colonoscopy. Endoscopy 35(4):300–304, 2003
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Ainley, E.J., Winwood, P.J. & Begley, J.P. Measurement of Serum Electrolytes and Phosphate After Sodium Phosphate Colonoscopy Bowel Preparation: An Evaluation. Dig Dis Sci 50, 1319–1323 (2005). https://doi.org/10.1007/s10620-005-2780-9
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DOI: https://doi.org/10.1007/s10620-005-2780-9