Top

Published in:

01-02-2005 | Case Reports

Hyponatremia and Seizures After Bowel Preparation: Report of Three Cases

Authors: F. A. Frizelle, M.B.Ch.B. , M.Med.Sc. , F.R.A.C.S., B. M. Colls, M.B.Ch.B. , F.R.A.C.P., F.R.C.P.

Published in: Diseases of the Colon & Rectum | Issue 2/2005

Abstract

Oral sodium phosphate and sodium picosulfates/magnesium citrate are commonly used to evacuate the colon and rectum before colonoscopy or colorectal surgery. These substances, however, are known to cause electrolyte abnormalities. Seizures caused by electrolyte abnormalities associated with bowel preparation have only rarely been reported. We report the cases of three patients with no prior history of seizures, who had their first seizure associated with hyponatremia following ingestion of sodium phosphate or sodium picosulfates/magnesium citrate combination. Care must be taken with patients with a low seizure threshold and those with possible chronic sodium depletion, such as patients on thiazide diuretics, who are undertaking bowel preparation with oral sodium phosphate or sodium picosulfates/magnesium citrate combination.

Mackey, AC, Shaffer, D, Prizant, R 2002Seizure associated with the use of Viscol for colonoscopyN Engl J Med3462095PubMed

Cohen, SM, Wexner, SD, Binderow, SR, et al. 1994Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleaning methodsDis Colon Rectum3768996PubMed

Regev, A, Fraser, G, Delpre, G, et al. 1998Comparison of two bowel preparations for colonoscopy: sodium picosulphate and magnesium citrate versus sulphate free polyethylene glycol lavage solutionAm J Gastroenterol93147882PubMed

Young, CJ, Simpson, RR, King, DW, Lubowski, DZ 2000Oral sodium phosphate solution is a superior colonoscopy preparation to polyethylene glycol with bisacodylDis Colon Rectum43156871PubMed

Chilton, AP, O’sullivan, M, Cox, MA, Loft, DE, Nwokolo, CU 2000A blinded, randomised comparison of a novel, low-dose, triple regimen with Fleet Phospo-Soda: a study of colon cleanliness, speed and success of colonoscopyEndoscopy323741PubMed

Sanders, G, Mercer, SJ, Saeb-Parsey, K, Akhavani, MA, Hosie, KB, Lambert, AW 2001Randomised clinical trial of intravenous fluid replacement during bowel preparation for surgeryBr J Surg8813635PubMed

Egesel, T, Sivri, B, Asik, M, Altun, B, Bayraktar, Y 2000A fatal complication of sodium-phosphate enemaTurk J Gastroenterol1133840

Campisi, P, Badhwar, V, Morin, S, Trudel, JL 1999Postoperative hypocalcemic tetany caused by fleet phospho-soda preparation in a patient taking alendronate sodium: report of a caseDis Colon Rectum421499501PubMed

Orias, M, Mahnensmith, RL, Perazella, MA 1999Extreme hyperphosphatemia and acute renal failure after phosphorous-containing bowel regimenAm J Nephrol19603PubMed

10.

Edwards, R, Mitchell, M, Twaddle, S 1998Hypophosphataemia in the critically ill patient-aetiology and managementCare Critically Ill1426770

11.

Soumoy, MP, Bachy, A 1998Severe phosphate enema poisoning in an infantArch Pediatr512213PubMedCrossRef

12.

Bozkaya, H, Ozturk, H, Uzun, Y, Ozden, A 1997Efficiency and safety of oral sodium phosphate cleansingTurk J Gastroenterol821721CrossRef

13.

Post, SS 1997Hyperphosphatemic hypocalcemic coma caused by hypertonic sodium phosphate (Fleet) enema intoxicationJ Clin Gastroenterol24192PubMed

14.

Ehrenpresis, ED, Wieland, JM, Cabral, J, Estevez, V, Zaitman, D, Secrest, K 1997Symptomatic hypocalcemia, hypomagnesemia, and hyperphosphatemia secondary to Fleets Phospho-Soda colonoscopy preparation in a patient with a jejunoileal bypassDig Dis Sci4285860PubMed

15.

Vukasin, P, Weston, LA, Beart, RW 1997Oral Fleet^® Phospho-Soda^® laxative-induced hyperphosphatemia and hypocalcemic tetany in an adult: report of a caseDis Colon Rectum404979PubMed

16.

Lambert, AM, Herman, RJ 1996Toxicity due to hypertonic sodium phosphate (Fleet) enema: approach to the constipated patientCan J Clin Pharmacol313944

17.

Boivin, MA, Kahn, SR 1998Symptomatic hypocalcemia from oral sodium phosphate: report of two casesAm J Gastroenterol9325779PubMed

18.

Ehrenpris, ED, Nogeras, JJ, Botoman, VA, Bonner, GF, Zaitman, D, Secrest, KM 1996Serum electrolyte abnormalities secondary to Fleet’s Phospo-Soda colonoscopy prep: a review of three casesSurg Endosc1010224PubMed

19.

Huynh, T, Vanner, S, Paterson, W 1995Saftey profile of 5-h oral sodium phosphate regimen for colonoscopy cleansing lack of clinically significant hypocalcemia or hypovolemiaAm J Gastroenterol901047PubMed

20.

DiPalma, JA, Buckley, SE, Warner, BA, Culpepper, RM 1996Biochemical effects or oral sodium phosphateDig Dis Sci4174953PubMed

21.

Knobel, B, Petchenko, P 1996Hyperphosphatemic hypocalcemic coma caused by hypertonic sodium phosphate (Fleet) enema intoxicationJ Clin Gastroenterol232179PubMed

22.

Filho, AJP, Lassman, MN 1996Severe hyperphosphatemia induced by a phosphate-containing oral laxativeAnn Pharmacother301413PubMed

23.

Fass, R, Do, S, Hixson, LJ 1993Fatal hyperphosphatemia following Fleet Phospo-Soda in a patient with colonic ileusAm J Gastroenterol8892932PubMed

24.

Korzets, A, Dicker, D, Chaimoff, C, Zevin, D 1992Life-threatening hyperphosphatemia and hypocalcemic tetany following the use of Fleet enemasJ Am Geriatr Soc406201PubMed

25.

Wason, S, Tiller, T, Cunha, C 1989Severe hyperphosphatemia, hypocalcemia, acidosis, and shock in a 5-month-old child following administration of an adult Fleet enemaAnn Emerg Med18696700PubMed

26.

Baxter Healthcare. Fleet Phospho-soda Buffered Saline Mixture; Data Sheet. Information for Health Professionals. Available at: www.medsafe.govt.nz/Profs/Datasheet/f/fleetphosphosoln.htm (accessed 01/01/2003).

27.

Hill, AG, Still, A, Parry, BR, Plank, LD, Hill, GL 1998Cellular potassium depletion predisposes to hypokalaemia after oral sodium phosphateANZ J Surg688568

28.

Kossoff, EH, Silvia, MT, Maret, A, Carakushansky, M, Vining, EP 2002Neonatal hypocalcemic seizures: case report and literature reviewJ Child Neurol172369PubMed

29.

Caksen, H, Odabas, D, Sar, S, et al. 2001Hyponatremic dehydration: an analysis of 78 casesInt Urol Nephrol334458PubMed

30.

Bhalla, P, Eaton, FE, Coulter, JB, Amegavine, FL, Stills, JA, Abernethy, LJ 1999Hyponatraemic seizures and excessive intake of hypotonic fluids in young childrenBMJ31915547PubMed

31.

Basnyat, B, Sleggs, J, Spinger, M 2000Seizures and delirium in a trekker: the consequences of excessive water drinking?Wilderness Environ Med116970PubMed

32.

Ayus, JC, Arieff, AI 1996Abnormalities of water metabolism in the elderlySemin Nephrol1627788PubMed

33.

Fritz, S, Mi-Plaza, P, Hust, MH, Bugler, HJ, Braun, B 1994A rare cause of hyponatremia: self-induced water intoxicationMed Klin892835PubMed

34.

Pais, P 1993Diuretic induced hyponatraemia in the elderlyJ Assoc Physicians India41228

35.

Adverse Event Reporting System (AERS). Rockville, Md: Center for Drug Evaluation and Research, Food and Drug Administration. Available at: www.fda.gov/cder/aers/default.htm (accessed 01/01/2003).

Title: Hyponatremia and Seizures After Bowel Preparation: Report of Three Cases
Authors: F. A. Frizelle, M.B.Ch.B. , M.Med.Sc. , F.R.A.C.S.
B. M. Colls, M.B.Ch.B. , F.R.A.C.P., F.R.C.P.
Publication date: 01-02-2005
Publisher: Springer-Verlag
Published in: Diseases of the Colon & Rectum / Issue 2/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI: https://doi.org/10.1007/s10350-004-0778-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Hyponatremia and Seizures After Bowel Preparation: Report of Three Cases

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2005

Practice Parameters for the Management of Hemorrhoids (Revised)

Lymph Node Metastases of Prostatic Adenocarcinoma in the Mesorectum in Patients With Adenocarcinoma or Villous Tumor of the Rectum With Collision Phenomenon in a Single Lymph Node: Report of Five Cases

Effective Laparoscopic Drainage for Intra-Abdominal Abscess Not Amenable to Percutaneous Approach: Report of Two Cases

Erratum

Validity and Reliability of the Modified Manchester Health Questionnaire in Assessing Patients With Fecal Incontinence

Modified Two-Stage Ileal Pouch-Anal Anastomosis: Equivalent Outcomes With Less Resource Utilization