Letters

Bowel preparation at home in elderly people

Patients should be warned not to drink too much or too little fluid

Editor–T D Heymann and colleagues report on the relative safety of bowel preparation at home in elderly people; none of their patients required admission to hospital.¹ We wish to report on two patients admitted in February and April of this year with serious complications of bowel preparation with sodium picosulphate (Picolax, Nordic) at home.

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

The . . . [Full text of this article]

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