FREQUENCY OF HYPONATREMIA IN PATIENTS TAKING SODIUM PICOSULFATE SOLUTION (SPS) SOLUTION FOR BOWEL PREPARATION PRIOR TO COLONOSCOPY
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Keywords
Frequency, Hyponatremia, Sodium Picosulfate Solution, bowel preparation, colonoscopy
Abstract
Background: Colonoscopy is a helpful technique in modern medicine that is being used more often for both therapeutic and diagnostic objectives. Its diagnostic efficacy is dependent on the manner in which the procedure is performed.
Objective: The aim of the current study was to explore the Frequency of hyponatremia in patients taking Sodium Picosulfate Solution (SPS) solution for bowel preparation prior to colonoscopy.
Methodology: The current study was carried out in medicine department at Ghulam Mohammad mahar medical college hospital sukkur from March 2021 to April 2022 after taking approval from the ethical committee of the institute. PASS 11 software was used to compute the sample size using a two-sided Z-test S (P0) with a difference (PI-P0) = 0.24. Participants receiving colonoscopies between the ages of 16 to 60 years of both gender were included. On the day before the colonoscopy, at 12 PM, each individual received two doses of 45 milliliters of SPS diluted in 400 milliliters of water. Serum sodium levels < 135 mEq/L7 were considered hyponatremia, whereas serum sodium levels > 145 mEq/L8 were considered hypernatremia. The data was analyzed through SPSS software version 25.
Results; A total of 58 individuals who underwent colonoscopy were included. The individual's mean age ±standard deviation was 40.1 ±15.2 years. Out of which 30 (51.7%) were males and 28 (48.2%) were females. Prior to using the colonoscopy solution, the average sodium level were 139.7 ±3.5 mEq/L. Of them, 6(10.3%) had values below 135 mEq/L, meaning they had hyponatremia prior to taking SPS, while 2 person (3.4%), had hypernatremia. Following SPS, the average sodium level was 138.9 ±3.8 mEq/L. Following SPS, hyponatremia was observed in 7 (12.0%) individuals and hypernatremia in 3 (5.1%) patients. It was discovered that there was no statistically significant change in the mean blood sodium levels prior to and following SPS (t(53) = 1.308; a p-value of 0.196).
Conclusion: None of our individuals had any significant side effects. Patients having colonoscopy before using SPS bowel preparation fluid and their blood sodium levels prior to the procedure did not significantly differ from one another.
References
2. Arora M OP. Use of Powder Peg-3350 as a Sole Bowel Preparation: Clinical Case Series of 245 Patients. Gastroenterol Hepatol. 2008;4(7):489-492.
3. Romero RV MS. Factors Influencing Quality of Bowel Preparation for Colonoscopy. World J Gastrointest Endosc. 2013;5(2):39-46.
4. Alan Barkun NC, Enns R, Marcon M, Natsheh N, Co Pham, Dan Sadowski, Stephen Vanner Commonly Used Preparations for Colonoscopy. Efficacy, Tolerability and Safety - A Canadian Association of Gastroenterology Position Paper. Can J Gastroenterol 2006;20(11):699-710.
5. Baeg MK, Park JM, Ko SH, Min GJ, Lee KJ, Yang JH, et al. Seizures Due to Hyponatremia Following Polyethylene Glycol Preparation; A Report of Two Cases. Endoscopy. 2013;45(Suppl 2 UCTN):E269-270.
6. Koshitani T KM, Yoshikawa T. Bowel Preparation for Colonoscopy Using Standard Vs Reduced Doses of Sodium Phosphate: A Single-Blind Randomized Controlled Study. World J Gastrointest Endosc. 2004;6(8):379-384.
7. Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, et al. Diagnosis, Evaluation and Treatment of Hyponatremia: Expert Panel Recommendations. Am J Med. 2013;126(10Suppl 1):S1-42.
8. Adrogue HJ, Madias NE. Hypernatremia. New Eng J Med. 2000; 342(20):1493-1499.
9. Seeff LC RT, Shapiro JA, Nadel MR, Manninen DL, Given LS, Dong FB, Winges LD, McKenna MT. How Many Endoscopies Are Performed for Colorectal Cancer Screening? Results from Cdc’s Survey of Endoscopic Capacity. Gastroenterol. 2004; 127(6):1670-1677.
10. Froehlich F WV, Gonvers JJ, Burnand B, Vader JP. Impact of Colonic Cleansing on Quality and Diagnostic Yield of Colonoscopy: The European Panel of Appropriateness of Gastrointestinal Endoscopy European Multicenter Study. Gastrointest Endosc. 2005;61(3):378-384.
11. Costa JM, Soares JB. Symptomatic Hyponatremia after Bowel Preparation: Report of Two Cases and Literature Review. Acta Med Port. 2017;30(11):824-826. doi: 10.20344/ amp.8794
12. Hoy SM SL, Wagstaff AJ. Sodium Picosulfate/Magnesium Citrate: A Review of Its Use as a Colorectal Cleanser. Drugs. 2009; 69(1):123-136.
13. Weir MA, Fleet JL, Vinden C, Shariff SZ, Liu K, Song H, et al. Hyponatremia and Sodium Picosulfate Bowel Preparations in Older Adults. Am J Gastroenterol. 2014; 109(5):686-694.
14. Cohen CD KC, Schiemann U, Schroppel B, Siegert S, Rascher W, Gross M, et al. Hyponatraemia as a Complication of Colonoscopy. Lancet. 2001; 357(9252):282-283.
15. Rahman A, Hookey LC. Serial Monitoring of the Physiological Effects of the Standard Pico-Salax® Regimen for Colon Cleansing in Healthy Volunteers. Can J Gastroenterol. 2012;26(7):424-428.
16. Scarpignato C, Blandizzi C. Editorial: Hyponatremia - a Possible but Forgotten Consequence of Bowel Preparation for Colonoscopy. Aliment Pharmacol Ther. 2014;40(9):1110-1112.
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Shahab uddin Rind
Senior Registrar gastroenterology and hepatology Ghulam Mohammad mahar medical college sukkur
Sanaullah Kalwar
Assistant Professor, Pir Abdul Qadir Shah Jilani Institue of Medical sciences, Gambat. Khairpur Mir’s
Abdul Rashid dayo
Assistant professor in medicine at Ghulam Mohammad mahar medical college hospital sukkur