Bowel preparation at home in elderly people

BMJ 1997;314:74 (4 January)

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Bowel preparation at home in elderly people

Patients should be warned not to drink too much or too littlefluid

Editor–T D Heymann and colleagues report on the relativesafety of bowel preparation at home in elderly people; noneof their patients required admission to hospital.¹ We wish toreport on two patients admitted in February and April of thisyear with serious complications of bowel preparation with sodium picosulphate(Picolax, Nordic) at home.

The first patient was an 85 year old woman who presented witha score on the Glasgow coma scale of 5/15 and a tonic clonicseizure, having drunk some 5 litres of water with the sodiumpicosulphate the previous day (patients receive typed instructionssaying "drink plenty of clear fluids"). On admission her serumsodium concentration was 111 mmol/l. She was treated with intravenoushypertonic saline and recovered fully over the next five days,her serum sodium concentration having returned to normal.

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