Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature Review

Authors

  • Juliana Moura Costa Gastroenterology Department. Hospital de Braga. Braga. Portugal.
  • João Bruno Soares Gastroenterology Department. Hospital de Braga. Braga. Portugal.

DOI:

https://doi.org/10.20344/amp.8794

Keywords:

Cathartics/adverse effects, Colonoscopy, Hyponatremia

Abstract

Introduction: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities.
Case Report: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl).
Discussion: Electrolyte imbalances are more common with sodium phosphate-based solutions (NaP) and sodium picosulfate/magnesium citrate, in patients older than 65, in patients treated with thiazide diuretics, angiotensin-converting-enzyme inhibitor, betablockers or antidepressants and in gastrectomized patients. These patients should use macrogol-based solutions (polyethylene glycol).
Conclusion: In patients at risk (patient > 65 years old, patients taking thiazide diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers and antidepressants and with previous gastrectomy) we recommend macrogol-based solutions.

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Published

2017-11-29

How to Cite

1.
Costa JM, Soares JB. Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature Review. Acta Med Port [Internet]. 2017 Nov. 29 [cited 2024 Nov. 8];30(11):824-6. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/8794

Issue

Section

Case Report