Frequency of hyponatremia caused by sodium picosulfate solution when used as a bowel cleansing agent for colonoscopy.

Tazeen Rasheed,Wara Subhan,Bader Faiyaz Zuberi,Majid Ahmed Shaikh,Faiza Sadaqat Ali,Haris Alvi

doi:10.12669/pjms.36.7.2376

Tazeen Rasheed, Wara Subhan + Show 4 more

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https://doi.org/10.12669/pjms.36.7.2376

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Abstract

Objective:To determine the frequency of hyponatremia in patients taking Sodium Picosulfate Solution (SPS) solution for bowel preparation prior to colonoscopy and to compare serum sodium levels before and after SPS.Methods:This interventional study was conducted at Dr. Ruth K. M. Pfau, Civil Hospital Karachi between June 2019 to November 2019. Patients undergoing colonoscopy were included in the study. All patients were given SPS. Two samples of blood for electrolytes were taken, one 30 minutes before taking SPS solution and another 30 minutes before colonoscopy. Paired sample t-test was used to determine the difference between serum sodium level before taking the colonoscopy solution and serum sodium level before colonoscopy.Results:Fifty- four patients fulfilling inclusion criteria were included. Out of the 54 patients 28 (51.9%) were males and 26 (48.1%) were females. Mean sodium levels before taking colonoscopy solution was 139.7 ±3.5 mEq/L and mean sodium level before colonoscopy was 138.9 ±3.8 mEq/L. The difference between serum sodium level before taking SPS colonoscopy solution and before colonoscopy was found to be statistically insignificant (t (53) = 1.308; p = 0.196).Conclusion:No serious adverse effects were reported in any of our patients. There was no significant difference in the serum sodium level of patients undergoing colonoscopy before taking SPS bowel preparation solution and serum sodium level before colonoscopy.

Highlights

Colonoscopy is a useful tool used in modern medicine and it is increasingly being availed for both diagnostic and therapeutic purposes
Bowel preparation for colonoscopy can lead to electrolyte abnormalities such as hyponatremia which may cause serious neurological consequences such as seizures, loss of consciousness and eventually coma.[5]
An adequately prepared colon is an important prerequisite for the success of colonoscopy since the quality of bowel cleansing is a crucial factor in determining the speed, difficulty and completeness of colonoscopy.[10]

Summary

Introduction

Colonoscopy is a useful tool used in modern medicine and it is increasingly being availed for both diagnostic and therapeutic purposes. Pak J Med Sci November - December 2020 Vol 36 No 7 www.pjms.org.pk 1651 sedatives and analgesics being required.[3] The most frequently used solutions for colonoscopy preparation are polyethylene glycol (PEG) Sodium Phosphate and Sodium Picosulfate (SPS).[4] Bowel preparation for colonoscopy can lead to electrolyte abnormalities such as hyponatremia which may cause serious neurological consequences such as seizures, loss of consciousness and eventually coma.[5] SPS acts in the colon as a stimulant laxative and increases the frequency and strength of peristalsis thereby causing diarrhoea.[6] there are some cases of hyponatremia reported due to its use. Fluid and electrolyte disturbances can occur more commonly in patients with risk factors, such as old age, use of SSRIs and thiazide diuretics, chronic kidney disease, congestive heart failure or with a history of electrolyte abnormalities.[1]

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