Hyponatremia and Seizures After Bowel Preparation: Report of Three Cases

Frizelle, Frank; Colls, B. M.

doi:10.1007/s10350-004-0778-6

Cited by 85 publications

(61 citation statements)

References 28 publications

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“…In 1972, Hughes originally questioned MBP and concluded that vigorous mechanical bowel preparation is unnecessary. 49 Not only does MBP cause metabolic and electrolyte imbalance, dehydration, abdominal pain/bloating and fatique, [50][51][52][53] but it may actually have detrimental effects on surgical outcome. 54 Multiple RCTs and meta-analyses have been published over the last decade suggesting that it is safe to abandon MBP.…”

Section: Role Of Mechanical Bowel Preparationmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

261

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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Section: Role Of Mechanical Bowel Preparationmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

261

120

View full text Add to dashboard Cite

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“…Patient with advanced age, potential chronic sodium depletion, such as patients on thiazide diuretics, or with baseline electrolyte disturbances are at high risk of developing significant hyponatremia [1,3]. Concurrent ingestion of free water, as in this case, may contribute to the development of severe hyponatremia.…”

Section: Discussionmentioning

confidence: 92%

“…Neurologic symptoms of hyponatremia include confusion, somnolence and loss of consciousness, seizures, permanent brain damage, and brain herniation. Only a few cases of hyponatremic seizure associated with magnesium citrate bowel preparation are published [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Hyponatremia-Induced Seizures Secondary to Magnesium Citrate Colon Cleansing Agent

Naidu¹,

Acharya²,

Alagappan³

et al. 2017

Emerg Med

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Mild and clinically insignificant electrolyte disturbances are a well-recognised complication of all bowel preparation. Seizure as a complication is very rare. Magnesium citrate, a hyperosmolar substance, is often used for bowel preparation before colonoscopy and colon surgery. We report a 74-years-old female, with no prior history of seizures, who had her first seizure associated with hyponatremia following ingestion of magnesium citrate for bowel preparation. A careful correction of serum sodium must be undertaken. The patient improved her mental status to baseline after intravenous infusion of hypertonic saline. The other causes of hyponatremia and seizure were ruled out. This case highlights the association between magnesium citrate bowel preparations with significant hyponatremia and seizure. The physicians in the ED and general practice need to be aware of this serious complication of magnesium citrate bowel preparation to diagnose them early and initiate timely management.

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“…7,[17][18][19] Our results showed that patients prepared with NaP and MN presented high serum sodium after the bowel preparation, being this elevation more significant on the MN patients. PS patients had a decrease in serum sodium, and differences were observed between PS compared to the other two groups.…”

Section: Discussionmentioning

confidence: 97%

Comparison of colon-cleansing methods in preparation for colonoscopy - Comparative efficacy of solutions of mannitol, sodium picosulfate and monobasic and dibasic sodium phosphates

et al. 2008

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PURPOSE: Colonoscopy plays an essential role in the therapeutic and diagnostic approach in various colonic pathologies, the aim of the present study was to compare three solutions and their efficacy for the bowel preparation in adult patients submitted to elective colonoscopy. METHODS: Sixty patients were randomly divided into three groups of 20 each. Each group was submitted to a bowel preparation with one of the following solutions: 10% manitol, sodium picosulphate or sodium phosphate. The parameters evaluated were: taste, tolerance, associated side effects and quality of cleansing. Postural blood pressure and pulse rate as well as serum sodium, potassium, calcium and phosphate were compared. RESULTS: Sodium phosphate and 10% manitol solutions provided superior results in terms of colon cleansing compared to sodium picosulphate solution. All serum electrolytes evaluated were significantly altered in the three groups, without important clinical signs. DISCUSSION: High levels of serum phosphate were the most striking alteration in patients prepared with sodium phosphate solution, again with no clinical signs. Variations related to blood pressure and pulse rate suggested contraction of intravascular volume, with no clinical effects. CONCLUSION: Sodium phosphate and 10% manitol solutions are equivalent in providing good quality colon cleansing, with no significant side effects that could compromise the procedure.

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Hyponatremia and Seizures After Bowel Preparation: Report of Three Cases

Cited by 85 publications

References 28 publications

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Hyponatremia-Induced Seizures Secondary to Magnesium Citrate Colon Cleansing Agent

Comparison of colon-cleansing methods in preparation for colonoscopy - Comparative efficacy of solutions of mannitol, sodium picosulfate and monobasic and dibasic sodium phosphates

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