scholarly journals Symptomatic Hyponatremia following Bowel Preparation for Colonoscopy: A Case Report

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Pramesh Sunder Shrestha ◽  
Utsav Acharya ◽  
Bipin Karki ◽  
Rahul Pathak ◽  
Subhash Prasad Acharya
Keyword(s):  
Case Report ◽  
Polyethylene Glycol ◽  
Antidiuretic Hormone ◽  
Bowel Preparation ◽  
Gold Standard ◽  
Sodium Phosphate ◽  
Electrolyte Disturbances ◽  
Sodium Picosulphate ◽  
Standard Tool ◽  
Colorectal Diseases

Colonoscopy is considered a gold standard tool for the diagnostic evaluation of colorectal diseases. Bowel preparation, a pre-requisite for colonoscopy, usually involves ingestion of purgatives for the cleansing of the bowel so that visualization is not obscured during the procedure. Commonly used preparations are sodium phosphate-based solutions, sodium picosulphate and polyethylene glycol. The use of such preparations is associated with electrolyte disturbances, commonly hyponatremia. Hyponatremia is usually seen with sodium phosphate based solutions and is rare with polyethylene glycol. Symptomatic hyponatremia, however, is rare following bowel preparation and is attributable to other factors as well, such as the age of patient, non-osmotic release of antidiuretic hormone and the procedure itself. In this report, we discuss a case of severe symptomatic hyponatremia observed in a 71-year-old gentleman who underwent polyethylene glycol based bowel preparation for colonoscopy.

scholarly journals Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

2008 ◽  
Vol 2008 ◽  
pp. 1-6 ◽  
Author(s):  
S. Schanz ◽  
W. Kruis ◽  
O. Mickisch ◽  
B. Küppers ◽  
P. Berg ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Adverse Events ◽  
Bowel Preparation ◽  
Sodium Phosphate ◽  
Vital Signs ◽  
Multicenter Trial ◽  
Phosphate Solution ◽  
Blinded Study ◽  
Sodium Phosphate Solution ◽  
Oral Sodium Phosphate

Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP) and polyethylene glycol-based lavage (PEG-ELS) are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides) in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C) receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4) of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L) (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71) were in favor of NaP (P = .005). Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015), B = 46.6% (versus C: P = .147), and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113). The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.

scholarly journals Nodular Esophageal Xanthoma: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmed Dirweesh ◽  
Muhammad Khan ◽  
Sumera Bukhari ◽  
Cheryl Rimmer ◽  
Robert Shmuts
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Gold Standard ◽  
Rare Case ◽  
Medical Literature ◽  
Black Female ◽  
Review Of The Literature ◽  
Standard Tool ◽  
English Medical Literature

Xanthomas are localized nonneoplastic lesions within tissues that may manifest as papules, plaques, or nodules. These lesions can be found anywhere along the gastrointestinal tract, commonly in the stomach and colon, and rarely in the small intestine and esophagus. Esophagogastroduodenoscopy (EGD) with biopsy is the gold standard tool for diagnosis. Here, we report a rare case of a lower solitary nodular esophageal xanthoma in an elderly black female. Correspondingly, all cases of esophageal xanthomas reported in the English medical literature were reviewed and presented with the reported case.

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