Systematic review: The adverse effects of sodium phosphate enema

Alimentary Pharmacology and Therapeutics

Volumn 26, Issue 1, 2007, Pages 9-20

  Mendoza, J ^a   Legido, J ^a   Rubio, S ^a   Gisbert, J P ^a,b  

^a HOSPITAL UNIVERSITARIO DE LA PRINCESA   (Spain)

^b NONE   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

ENEMA; SODIUM DIHYDROGEN PHOSPHATE;

ACUTE KIDNEY FAILURE; ACUTE RESPIRATORY FAILURE; AGE DISTRIBUTION; ANORECTAL MALFORMATION; ASTHMA; BARIUM ENEMA; CAT CRY SYNDROME; CHRONIC KIDNEY FAILURE; COCHRANE LIBRARY; COLONOSCOPY; COMORBIDITY; CONSTIPATION; DATA ANALYSIS; DIAGNOSTIC TEST; DISEASE ASSOCIATION; DISEASE SEVERITY; DRUG EFFICACY; DRUG SAFETY; ELECTROLYTE DISTURBANCE; EPILEPSY; FEVER; GASTROINTESTINAL MOTILITY DISORDER; GAUCHER DISEASE; HEART DISEASE; HEART FAILURE; HIRSCHSPRUNG DISEASE; HUMAN; HYPERNATREMIA; HYPERPHOSPHATEMIA; HYPOCALCEMIA; HYPOKALEMIA; HYPONATREMIA; INFORMATION PROCESSING; INTERNET; INTRAVASCULAR HEMOLYSIS; KIDNEY FAILURE; KIDNEY POLYCYSTIC DISEASE; LYMPHOMA; MEDLINE; MENINGOMYELOCELE; METABOLIC ACIDOSIS; METABOLIC DISORDER; MORTALITY; MULTIPLE ORGAN FAILURE; MUSCULAR DYSTROPHY; NEUROGENIC BLADDER; NEUROLOGIC DISEASE; PREMATURITY; PRIORITY JOURNAL; QT PROLONGATION; RECTUM TUMOR; REVIEW; RISK FACTOR; SEX RATIO; SHOCK; SIDE EFFECT; SPINAL MUSCULAR ATROPHY; SYNDROME VATER; TETANY; TREATMENT INDICATION;

ADOLESCENT; ADULT; AGED; CHILD; CHILD, PRESCHOOL; CONSTIPATION; ENEMA; FEMALE; HUMANS; INFANT; MALE; MIDDLE AGED; PHOSPHATES; RISK FACTORS; TREATMENT OUTCOME; WATER-ELECTROLYTE IMBALANCE;

EID: 34250009759     PISSN: 02692813     EISSN: 13652036     Source Type: Journal    
DOI: 10.1111/j.1365-2036.2007.03354.x     Document Type: Review

References (75)

1. Harrington L, Schuh S. Complications of Fleet enema administration and suggested guidelines for use in the pediatric emergency department. Pediatr Emerg Care 1997 13 : 225 6.
2. Atkin WS, Hart A, Edwards R, et al. Single blind, randomised trial of efficacy and acceptability of oral picolax versus self administered phosphate enema in bowel preparation for flexible sigmoidoscopy screening. BMJ 2000 320 : 1504 8 discussion 1509.
3. Osgard E, Jackson JL, Strong J. A randomized trial comparing three methods of bowel preparation for flexible sigmoidoscopy. Am J Gastroenterol 1998 93 : 1126 30.
4. Bowers B. Evaluating the evidence for administering phosphate enemas. Br J Nurs 2006 15 : 378 81.
5. Laxatives for bowel clearing before investigations. Drug Ther Bull 2002 40 : 86 8.
6. Herman M, Shaw M, Loewen B. Comparison of three forms of bowel preparations for screening flexible sigmoidoscopy. Gastroenterol Nurs 2001 24 : 178 81.
7. Toledo TK, DiPalma JA. Review article: colon cleansing preparation for gastrointestinal procedures. Aliment Pharmacol Ther 2001 15 : 605 11.
8. Fincher RK, Osgard EM, Jackson JL, et al. A comparison of bowel preparations for flexible sigmoidoscopy: oral magnesium citrate combined with oral bisacodyl, one hypertonic phosphate enema, or two hypertonic phosphate enemas. Am J Gastroenterol 1999 94 : 2122 7.
9. Manoucheri M, Nakamura DY, Lukman RL. Bowel preparation for flexible sigmoidoscopy: which method yields the best results? J Fam Pract 1999 48 : 272 4.
10. Preston KL, Peluso FE, Goldner F. Optimal bowel preparation for flexible sigmoidoscopy-are two enemas better than one? Gastrointest Endosc 1994 40 : 474 6.
11. Barrish JO, Gilger MA. Colon cleanout preparations in children and adolescents. Gastroenterol Nurs 1993 16 : 106 9.
12. Krevsky B, Niewiarowski T, League R, et al. Flexible sigmoidoscopy screening in an industrial setting. Am J Gastroenterol 1992 87 : 1759 62.
13. Sugimura F, Ryoh H, Watanabe T, et al. Comparative studies on the usefulness of phosphate versus glycerin enema in preparation for colon examinations. Gastroenterol Jpn 1990 25 : 437 50.
14. Richter KP, Cleveland MB. Comparison of an orally administered gastrointestinal lavage solution with traditional enema administration as preparation for colonoscopy in dogs. J Am Vet Med Assoc 1989 195 : 1727 31.
15. Mulder CJ, Tytgat GN, Wiltink EH, et al. Comparison of 5-aminosalicylic acid (3 g) and prednisolone phosphate sodium enemas (30 mg) in the treatment of distal ulcerative colitis. A prospective, randomized, double-blind trial. Scand J Gastroenterol 1988 23 : 1005 8.
16. Mulder CJ, Endert E, van der Heide H, et al. Comparison of beclomethasone dipropionate (2 and 3 mg) and prednisolone sodium phosphate enemas (30 mg) in the treatment of ulcerative proctitis. An adrenocortical approach. Neth J Med 1989 35 : 18 24.
17. van der Heide H, van den Brandt-Gradel V, Tytgat GN, et al. Comparison of beclomethasone dipropionate and prednisolone 21-phosphate enemas in the treatment of ulcerative proctitis. J Clin Gastroenterol 1988 10 : 169 72.
18. Jorgensen LS, Center SA, Randolph JF, et al. Electrolyte abnormalities induced by hypertonic phosphate enemas in two cats. J Am Vet Med Assoc 1985 187 : 1367 8.
19. Somerville KW, Langman MJ, Kane SP, et al. Effect of treatment on symptoms and quality of life in patients with ulcerative colitis: comparative trial of hydrocortisone acetate foam and prednisolone 21-phosphate enemas. Br Med J (Clin Res Ed) 1985 291 : 866.
20. Atkins CE, Tyler R, Greenlee P. Clinical, biochemical, acid-base, and electrolyte abnormalities in cats after hypertonic sodium phosphate enema administration. Am J Vet Res 1985 46 : 980 8.
21. McCallum RW, Meyer CT, Marignani P, et al. Flexible sigmoidoscopy: diagnostic yield in 1015 patients. Am J Gastroenterol 1984 79 : 433 7.
22. Lambert R, Olive C, Melange M, et al. Flexible rectosigmoidoscopy in the detection of tumoral colonic lesions. Endoscopy 1978 10 : 284 8.
23. Powell-Tuck J, Lennard-Jones JE, May CS, et al. Plasma prednisolone levels after administration of prednisolone-21-phosphate as a retention enema in colitis. Br Med J 1976 1 : 193 5.
24. Pinfield A, Stringer MD. Randomised trial of two pharmacological methods of bowel preparation for day case colonoscopy. Arch Dis Child 1999 80 : 181 3.
25. Dahshan A, Lin CH, Peters J, et al. A randomized, prospective study to evaluate the efficacy and acceptance of three bowel preparations for colonoscopy in children. Am J Gastroenterol 1999 94 : 3497 501.
26. Cohan CF, Kadakia SC, Kadakia AS. Serum electrolyte, mineral, and blood pH changes after phosphate enema, water enema, and electrolyte lavage solution enema for flexible sigmoidoscopy. Gastrointest Endosc 1992 38 : 575 8.
27. Platell C, Barwood N, Makin G. Randomized clinical trial of bowel preparation with a single phosphate enema or polyethylene glycol before elective colorectal surgery. Br J Surg 2006 93 : 427 33.
28. Schuchmann GD, Barcia PJ. Phosphate absorption from fleet enemas in adults. Curr Surg 1989 46 : 120 2.
29. Hu MS, Kayne LH, Jamgotchian N, et al. Paracellular phosphate absorption in rat colon: a mechanism for enema-induced hyperphosphatemia. Miner Electrolyte Metab 1997 23 : 7 12.
30. Lochbuhler H, Sachs J, Raute-Kreinsen U. The pharmacological effect of sodium phosphate after absorption from the peritoneal cavity. Eur J Pediatr Surg 1995 5 : 84 7.
31. Gutierrez E. Purgative with high sodium phosphate contents: efficacious but not so safe. Med Clin (Barc) 2006 126 : 173 4.
32. Everman DB, Nitu ME, Jacobs BR. Respiratory failure requiring extracorporeal membrane oxygenation after sodium phosphate enema intoxication. Eur J Pediatr 2003 162 : 517 9.
33. Walton DM, Thomas DC, Aly HZ, et al. Morbid hypocalcemia associated with phosphate enema in a six-week-old infant. Pediatrics 2000 106 : E37.
34. Rimensberger P, Schubiger G, Willi U. Connatal rickets following repeated administration of phosphate enemas in pregnancy: a case report. Eur J Pediatr 1992 151 : 54 6.
35. Wason S, Tiller T, Cunha C. Severe hyperphosphatemia, hypocalcemia, acidosis, and shock in a 5-month-old child following the administration of an adult Fleet enema. Ann Emerg Med 1989 18 : 696 700.
36. Martin RR, Lisehora GR, Braxton M Jr., et al. Fatal poisoning from sodium phosphate enema. Case report and experimental study. JAMA 1987 257 : 2190 2.
37. Reedy JC, Zwiren GT. Enema-induced hypocalcemia and hyperphosphatemia leading to cardiac arrest during induction of anesthesia in an outpatient surgery center. Anesthesiology 1983 59 : 578 9.
38. Davis RF, Eichner JM, Bleyer WA, et al. Hypocalcemia, hyperphosphatemia, and dehydration following a single hypertonic phosphate enema. J Pediatr 1977 90 : 484 5.
39. Honig PJ, Holtzapple PG. Hypocalcemic tetany following hypertonic phosphate enemas. Clin Pediatr (Phila) 1975 14 : 678 9.
40. Moseley PK, Segar WE. Fluid and serum electrolyte disturbances as a complication of enemas in Hirschsprung's disease. Am J Dis Child 1968 115 : 714 8.
41. Ismail EA, Al-Mutairi G, Al-Anzy H. A fatal small dose of phosphate enema in a young child with no renal or gastrointestinal abnormality. J Pediatr Gastroenterol Nutr 2000 30 : 220 1.
42. Craig JC, Hodson EM, Martin HC. Phosphate enema poisoning in children. Med J Aust 1994 160 : 347 51.
43. McCabe M, Sibert JR, Routledge PA. Phosphate enemas in childhood: cause for concern. BMJ 1991 302 : 1074.
44. Gomez Rivas B, Labay Matias M, Reynes Muntaner J, et al. Hypocalcemic tetany caused by a phosphate enema. An Esp Pediatr 1981 14 : 143 4.
45. Melvin JD, Watts RG. Severe hypophosphatemia: a rare cause of intravascular hemolysis. Am J Hematol 2002 69 : 223 4.
46. Ballesteros Garcia M, Sanchez Diaz JI, Mar Molinero F. Poisoning after the use of sodium phosphate enema. An Esp Pediatr 2001 55 : 92 3.
47. Helikson MA, Parham WA, Tobias JD. Hypocalcemia and hyperphosphatemia after phosphate enema use in a child. J Pediatr Surg 1997 32 : 1244 6.
48. Franch F, Verd F, Hernandez P, et al. Hypocalcemic tetany following the administration of phosphate enema. Rev Esp Anestesiol Reanim 1995 42 : 35 6.
49. Hunter MF, Ashton MR, Griffiths DM, et al. Hyperphosphataemia after enemas in childhood: prevention and treatment. Arch Dis Child 1993 68 : 233 4.
50. Edmondson S, Almquist TD. Iatrogenic hypocalcemic tetany. Ann Emerg Med 1990 19 : 938 40.
51. Forman J, Baluarte HJ, Gruskin AB. Hypokalemia after hypertonic phosphate enemas. J Pediatr 1979 94 : 149 51.
52. Sotos JF, Cutler EA, Finkel MA, et al. Hypocalcemic coma following two pediatric phosphate enemas. Pediatrics 1977 60 : 305 7.
53. Oxnard SC, O'Bell J, Grupe WE. Severe tetany in an azotemic child related to a sodium phosphate enema. Pediatrics 1974 53 : 105 6.
54. Swerdlow DB, Labow S, D'Anna J. Tetany and enemas: report of a case. Dis Colon Rectum 1974 17 : 786 7.
55. Marraffa JM, Hui A, Stork CM. Severe hyperphosphatemia and hypocalcemia following the rectal administration of a phosphate-containing Fleet pediatric enema. Pediatr Emerg Care 2004 20 : 453 6.
56. Butani L. Life-threatening hyperphosphatemia and hypocalcemia from inappropriate use of Fleet enemas. Clin Pediatr (Phila) 2005 44 : 93.
57. Pitcher DE, Ford RS, Nelson MT, et al. Fatal hypocalcemic, hyperphosphatemic, metabolic acidosis following sequential sodium phosphate-based enema administration. Gastrointest Endosc 1997 46 : 266 8.
58. Haskell LP. Hypocalcaemic tetany induced by hypertonic-phosphate enema. Lancet 1985 2 : 1433.
59. Young JF, Brooke BN. Enema shock in Hirschsprung's disease. Dis Colon Rectum 1968 11 : 391 5.
60. Eckstein J, Savic S, Eugster T, et al. Extensive calcifications induced by hyperphosphataemia caused by phosphate-based enema in a patient after kidney transplantation. Nephrol Dial Transplant 2006 21 : 2013 6.
61. Tan HL, Liew QY, Loo S, et al. Severe hyperphosphataemia and associated electrolyte and metabolic derangement following the administration of sodium phosphate for bowel preparation. Anaesthesia 2002 57 : 478 83.
62. Martinez Velasco MC, Ahmad al Ghool M, Sos Ortigosa F, et al. Acute hyperphosphatemia induced by enemas. Med Clin (Barc) 1998 110 : 805.
63. Knobel B, Petchenko P. Hyperphosphatemic hypocalcemic coma caused by hypertonic sodium phosphate (fleet) enema intoxication. J Clin Gastroenterol 1996 23 : 217 9.
64. Sutters M, Gaboury CL, Bennett WM. Severe hyperphosphatemia and hypocalcemia: a dilemma in patient management. J Am Soc Nephrol 1996 7 : 2056 61.
65. Korzets A, Dicker D, Chaimoff C, et al. Life-threatening hyperphosphatemia and hypocalcemic tetany following the use of fleet enemas. J Am Geriatr Soc 1992 40 : 620 1.
66. Aradhye S, Brensilver JM. Sodium phosphate-induced hypernatremia in an elderly patient: a complex pathophysiologic state. Am J Kidney Dis 1991 18 : 609 11.
67. Spinrad S, Sztern M, Grosskopf Y, et al. Treating constipation with phosphate enema: an unnecessary risk. Isr J Med Sci 1989 25 : 237 8.
68. Biberstein M, Parker BA. Enema-induced hyperphosphatemia. Am J Med 1985 79 : 645 6.
69. Rohack JJ, Mehta BR, Subramanyam K. Hyperphosphatemia and hypocalcemic coma associated with phosphate enema. South Med J 1985 78 : 1241 2.
70. Farah R. Fatal acute sodium phosphate enemas intoxication. Acta Gastroenterol Belg 2005 68 : 392 3.
71. Smith I, Carr N, Corrado OJ, et al. Rectal necrosis after a phosphate enema. Age Ageing 1987 16 : 328 30.
72. Sweeney JL, Hewett P, Riddell P, et al. Rectal gangrene: a complication of phosphate enema. Med J Aust 1986 144 : 374 5.
73. Pietsch JB, Shizgal HM, Meakins JL. Injury by hypertonic phosphate enema. Can Med Assoc J 1977 116 : 1169 70.
74. Bell AM. Colonic perforation with a phosphate enema. J R Soc Med 1990 83 : 54 5.
75. Post SS. Hyperphosphatemic hypocalcemic coma caused by hypertonic sodium phosphate (fleet) enema intoxication. J Clin Gastroenterol 1997 24 : 192.