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Suggest Treatment For Hyponatremia And Hypokalemia

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Posted on Fri, 21 Nov 2014
Question: What surveillance protocol and what type of colonoscopy prep would be implemented as an inpatient for an individual as I, who had to cancel his most recent colonoscopy secondary to developing hyponatremia and hypokalemia during administration with Polyethylene Glycol?
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Answered by Dr. Suresh Raghavaiah (3 hours later)
Brief Answer:
Tap water enema

Detailed Answer:
Hello Mr Anwsexton,
How are you? My name is Dr Suresh Raghavaiah. I am a Surgical Gastroenterologist and I hope to answer your question today.
I am sorry to hear about your complication. Hyponatremia and hypokalemia are common complications following a severe bout of diarrhoea. In normal conditions just oral intake of extra rehydration salts usually suffices to correct the same. It is very rare for someone to develop these conditions after a preparation for colonoscopy although mild alterations in the levels are the norm. I am sorry you had to develop it.
There are a couple of strategies which your treating doctor might use to combat the same this time.
1. Repeat the Polyethylene Glycol itself but after starting you on intravenous supplementation of both sodium (in the form of sodium chloride drip) and also Potassium supplementation (usually added to the sodium chloride drip). This is the normal policy at our hospital in patients who show any kind of electrolyte imbalance on their screening blood work.
2. If on the other hand, your electrolyte imbalance was severe the first time around, then I am sure your doctor will advise a "High bowel wash" or a "Tap water enema" to cleanse out your colon before the procedure.
In both cases I am sure there will be blood work done, both before and after the process to measure your electrolyte levels and to make sure you don t develop hypo natraemia / kalaemia.

Hope this helps and hope you start to feel better.

Please do not hesitate to write back for clarifications.
Have a great day

Dr Suresh Raghavaiah
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Suresh Raghavaiah

Gastroenterologist, Surgical

Practicing since :2003

Answered : 164 Questions

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Suggest Treatment For Hyponatremia And Hypokalemia

Brief Answer: Tap water enema Detailed Answer: Hello Mr Anwsexton, How are you? My name is Dr Suresh Raghavaiah. I am a Surgical Gastroenterologist and I hope to answer your question today. I am sorry to hear about your complication. Hyponatremia and hypokalemia are common complications following a severe bout of diarrhoea. In normal conditions just oral intake of extra rehydration salts usually suffices to correct the same. It is very rare for someone to develop these conditions after a preparation for colonoscopy although mild alterations in the levels are the norm. I am sorry you had to develop it. There are a couple of strategies which your treating doctor might use to combat the same this time. 1. Repeat the Polyethylene Glycol itself but after starting you on intravenous supplementation of both sodium (in the form of sodium chloride drip) and also Potassium supplementation (usually added to the sodium chloride drip). This is the normal policy at our hospital in patients who show any kind of electrolyte imbalance on their screening blood work. 2. If on the other hand, your electrolyte imbalance was severe the first time around, then I am sure your doctor will advise a "High bowel wash" or a "Tap water enema" to cleanse out your colon before the procedure. In both cases I am sure there will be blood work done, both before and after the process to measure your electrolyte levels and to make sure you don t develop hypo natraemia / kalaemia. Hope this helps and hope you start to feel better. Please do not hesitate to write back for clarifications. Have a great day Dr Suresh Raghavaiah