USEFULNESS OF SERUM ELECTROLYTE EXAMINATION AFTER MECHANICAL BOWEL PREPARATION
Keywords:
Serum electrolyte, colonoscopy, bowel preparation, sodium phosphate, polyethylene glycolAbstract
Background and objectives: Quality of colonic preparation is a crucial part for accuracy and safety of colonoscopy that should be effective, safe, and well-tolerated by patients. Polyethylene glycol (PEG) and sodium phosphate (NaP) solutions are the most regularly used preparation and might lead to adverse events. There was no consensus about usefulness of serum electrolyte examination after bowel preparation. Aim of this study to determine the usefulness of serum electrolyte examination after bowel preparation. Methods: From July 2017 to December 2017, patients who underwent mechanical bowel preparation for elective colonoscopy were enrolled. Patient demographic data and serum electrolyte levels were recorded and evaluated. Results: 100 patients were included in this study. Of these, 15 patients had hypokalemia after bowel preparation. 14 patients developed mild hypokalemia and only 1 patient developed moderate hypokalemia. There were no adverse event during the operation and no significant risk factors were identified on multivariate analysis.Conclusions: In patients who undergo elective colonoscopy, are given the appropriate bowel preparation agent the changing of the serum electrolyte level after bowel preparation are mild and not clinically significant. Routine testing for serum electrolyte after bowel preparation seem to not necessary in these patient.
References
Ainley, E.J., Winwood, P.J., and Begley, J.P. (2005). Measurement of serum electrolytes and phosphate after sodium phosphate colonoscopy bowel preparation: an evaluation. Dig Dis Sci., 50(7):1,319-1,323.
Beloosesky, Y., Grinblat, J., Weiss, A., Grosman, B., Gafter, U., and Chagnac, A. (2003). Electrolyte disorders following oral sodium phosphate administration for bowel cleansing in elderly patients. Arch Intern Med., 163(7):803-808.
Cheon, J.H. and Kim, W.H. (2007). Recent advances of endoscopy in inflammatory bowel diseases. Gut Liver., 1(2):118-125.
Cohen, S.M., Wexner, S.D., Binderow, S.R., Nogueras, J.J., Daniel, N., Ehrenpreis, E.D., Jensen, J., Bonner, G.F., and Ruderman, W.B. (1994). Prospective, randomized, endoscopic-blinded trial comparing precolonoscopy bowel cleansing methods. Dis Colon Rectum., 37(7):689-696.
Committee, A.S.O.P., Saltzman, J.R., Cash, B.D., Pasha, S.F., Early, D.S., Muthusamy, V.R., Khashab, M.A., Chathadi, K.V., Fanelli, R.D., Chandrasekhara, V., Lightdale, J.R., Fonkalsrud, L., Shergill, A.K., Hwang, J.H., Decker, G.A., Jue, T.L., Sharaf, R., Fisher, D.A., Evans, J.A., Foley, K., Shaukat, A., Eloubeidi, M.A., Faulx, A.L., Wang, A., and Acosta, R.D. (2015). Bowel preparation before colonoscopy. Gastrointest Endosc., 81(4):781-794.
DeCosse, J.J., Tsioulias, G.J., and Jacobson, J.S. (1994). Colorectal cancer: detection, treatment, and rehabilitation. CA Cancer J. Clin., 44(1):27-42.
Kan, W.C., Wang, H.Y., Chien, C.C., Tan, C.K., Lin, C.Y., and Su, S.B. (2012). Intermediate bioelectrolyte changes after phospho-soda or polyethylene glycol precolonoscopic laxatives in a population undergoing health examinations. Nephrol Dial TX., 27(2):752-757.
Kastenberg, D., Bertiger, G., and Brogadir, S. (2018). Bowel preparation quality scales for colonoscopy. World J. Gastroenterol., 24(26):2,833-2,843.
Komeda, Y., Suzuki, N., Sarah, M., Thomas-Gibson, S., Vance, M., Fraser, C., Patel, K., and Saunders, B.P. (2013). Factors associated with failed polyp retrieval at screening colonoscopy. Gastrointest Endosc., 77(3):395-400.
Kumagai, E., Shibuya, T., Makino, M., Murakami, T., Takashima, S., Ritsuno, H., Ueyama, H., Kodani, T., Sasaki, H., Matsumoto, K., Sakamoto, N., Osada, T., Nagahara, A., Ogihara, T., and Watanabe, S. (2014). A Randomized prospective study of bowel preparation for colonoscopy with low-dose sodium phosphate tablets versus polyethylene glycol electrolyte solution. Gastroenterol. Res Pract., 2014:879749.
Lee, K.J., Park, H.J., Kim, H.-S., Baik, K.H., Kim, Y.S., Park, S.C., and Seo, H.I. (2015). Electrolyte changes after bowel preparation for colonoscopy: A randomized controlled multicenter trial. World j. gastroenterology, 21(10):3,041-3,048.
Lee, S.H., Lee, D.J., Kim, K.M., Seo, S.W., Kang, J.K., Lee, E.H., and Lee, D.R. (2014). Comparison of the efficacy and safety of sodium phosphate tablets and polyethylene glycol solution for bowel cleansing in healthy Korean adults. Yonsei Med. J., 55(6):1,542-1,555.
Reilly, T. and Walker, G. (2004). Reasons for poor colonic preparation with inpatients. Gastroenterol. Nursing., 27(3):115-117
Virani, S., Bilheem, S., Chansaard, W., Chitapanarux, I., Daoprasert, K., Khuanchana, S., Leklob, A., Pongnikorn, D., Rozek, L.S., Siriarechakul, S., Suwanrungruang, K., Tassanasunthornwong, S., Vatanasapt, P., and Sriplung, H. (2017). National and subnational population-based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens. Cancers., 9(8):108.
