Introduction: Bowel preparation for colonoscopy and/or colorectal surgery can cause electrolyte imbalances. The risk of electrolyte imbalances seems to be related to the type of bowel cleansing solution, age of patients and comorbidities.
Case Report: We report two cases of symptomatic hyponatremia (focal neurological signs and coma) after bowel preparation with sodium picosulfate/magnesium citrate for colonoscopy. In both cases, symptoms related to hyponatremia rapidly disappeared after sodium level correction with intravenous administration of hypertonic saline (3% NaCl).
Discussion: Electrolyte imbalances are more common with sodium phosphate-based solutions (NaP) and sodium picosulfate/magnesium citrate, in patients older than 65, in patients treated with thiazide diuretics, angiotensin-converting-enzyme inhibitor, betablockers or antidepressants and in gastrectomized patients. These patients should use macrogol-based solutions (polyethylene glycol).
Conclusion: In patients at risk (patient > 65 years old, patients taking thiazide diuretics, angiotensin-converting-enzyme inhibitors, beta-blockers and antidepressants and with previous gastrectomy) we recommend macrogol-based solutions.
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http://dx.doi.org/10.20344/amp.8794 | DOI Listing |
Dig Liver Dis
January 2025
Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, 00168, Roma, Italy.
Background And Aims: Adenoma detection rate (ADR) serves as a primary quality metric in colonoscopy. Various computer-aided detection (CADe) tools have emerged, yielding diverse impacts on ADR across different demographic cohorts. This study aims to evaluate a new CADe system in patients undergoing colonoscopy.
View Article and Find Full Text PDFObjective: To describe our experience with anorectal malformation (ARM) patients, while analyzing complications and risk factors.
Materials And Methods: A retrospective study of ARM patients aged 0-18 years old undergoing surgery from 2006 to 2023 was carried out. Demographic variables, associated malformations, age and repair surgery operating times, presence and type of colostomy, previous intestinal preparation, and presence and type of surgical complications -intestinal occlusion, anal prolapse, stenosis, bleeding, dehiscence, extrusion, anoplasty misposition, urethral perforation, and stomal complications- were collected.
Gynecol Oncol Rep
February 2025
Dept of Surgical Oncology, Aster International Institute of Oncology, Bangalore, India.
Background: The role of enhanced recovery after surgery (ERAS) in cytoreductive surgery and/or Hyperthermic Intraperitoneal Chemotherapy HIPEC) is evolving, with promising results that improve patient outcomes. This consensus exercise was carried out to address and standardize components of the ERAS protocol pertinent to the Indian context.
Method: The modified Delphi method was employed with two rounds of voting.
World J Gastroenterol
January 2025
Department of Gastroenterology (Endoscopy Center), China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China.
The term "gut microbiota" primarily refers to the ecological community of various microorganisms in the gut, which constitutes the largest microbial community in the human body. Although adequate bowel preparation can improve the results of colonoscopy, it may interfere with the gut microbiota. Bowel preparation for colonoscopy can lead to transient changes in the gut microbiota, potentially affecting an individual's health, especially in vulnerable populations, such as patients with inflammatory bowel disease.
View Article and Find Full Text PDFContemp Clin Trials
January 2025
Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, USA; Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, California, USA; School of Medicine, University of California San Francisco, San Francisco, California, USA. Electronic address:
Background: Fecal immunochemical testing (FIT) is a widely used first step for colorectal cancer (CRC) screening. Abnormal FIT results require a colonoscopy for screening completion and CRC diagnosis, but the rate of timely colonoscopy is low, especially among patients in safety-net settings. Multi-level factors at the clinic- and patient-levels influence colonoscopy completion after an abnormal FIT.
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