“Bowel prep hyponatremia“ – a state of acute water intoxication facilitated by low dietary solute intake: case report and literature review

Table 1 Characteristics and presentation of patients with symptomatic hyponatremia related to bowel preparation reported in the literature

Reference	Age	Gender	Na Nadir	Presentation	Prep	Time	Diet	U_osm	U_Na	U_K
4	54	f	119	Bizarre behavior	4.5 l PEG	-	-	-	-	-
9	59	f	120	Seizure	3 l PEG-ELS + 4 l tea	7	-	185	22	5
10	62	f	116	Seizure	4 l PEG-ELS + water	-	-	-	-	-
11	75	f	116	Seizure	SP	-	-	-	-	-
11	64	f	111	Seizure	SPS/MC	-	-	-	-	-
11	24	f	132	Seizure	SP	-	-	-	-	-
12	79	f	108	Coma	“cathartics”	-	-	-	-	-
13	73	f	117	Seizure	PEG + 64 ounces of Gatorade	-	-	390	146	35.7
14	80	f	110	Seizure	SPS/MC	-	-	-	-	-
15	70	f	110	Seizure	4 l PEG + 3 l water	-	-	-	-	-
15	65	f	127	Seizure	4 l PEG	-	-	-	-	-
16	34	m	117	Encephalopathy	Bis + Man + > 6 l water	-	small breakfast, broth	-	-	-
17	57	f	120	Rhabdomyolysis	SPS/MC + Bis	-	liquid diet for 3 days	-	67	24
18	69	f	113	Seizure	4 l PEG	-	-	344	122	28.5
19	76	f	112	Seizure	SPS/MC	-	-	370	-	-
Present case	61	f	122	Encephalopathy	2 l SPS/MC + 2 l tea	2	broth, rusk for 2 days	232	39	-

Abbreviations: Na-Nadir lowest serum sodium concentration recorded (mmol/l), Prep type of bowel preparation used and amount of fluid ingested in preparation for endoscopy (l), time speed of fluid ingestion (hours), U osm urine osmolality (mosm/l), U _Na urine sodium (mmol/l) U _k urine potassium (mmol/l), PEG polyethylene glycol, PEG-ELS PEG/electrolyte lavage solution, SP sodium phosphate, SPS/MC sodium picosulfate/magnesium citrate, Bis/Man bisacodyl/mannitol

ISSN: 1471-2369