Effects of sodium phosphate rectal: A Synthesis of Findings from 16 Studies

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Original Abstract of the Article

Major Research Findings

Sodium phosphate enemas are commonly used for bowel cleansing before colonoscopies and for treating constipation. However, several studies have highlighted potential risks associated with their use, including hyperphosphatemia, dehydration, and electrolyte imbalances. 6 reported a case where a patient died due to severe hyperphosphatemia after using oral phosphosoda for bowel preparation. Moreover, 2 found that sodium phosphate enemas can lead to elevated serum phosphate levels. Additionally, 9 reported a case of hyperphosphatemia in a patient with liver dysfunction and chronic renal failure following the use of a sodium phosphate enema. These studies suggest that sodium phosphate enemas may pose a risk for severe metabolic disturbances.

On the other hand, 3 found that sodium picosulfate/magnesium citrate is an effective bowel cleansing agent for colonoscopies. However, this study didn't directly compare sodium phosphate enemas with other bowel cleansing agents, leaving it unclear if sodium phosphate enemas are superior.

4 compared the safety and efficacy of milk and molasses enemas versus sodium phosphate enemas for treating constipation in a pediatric emergency department. They found milk and molasses enemas to be safer and more effective than sodium phosphate enemas, suggesting potentially safer alternatives for children.

In summary, while sodium phosphate enemas can be effective for bowel cleansing, the possibility of severe metabolic complications exists. It's crucial to carefully consider individual patient factors and exercise caution when using sodium phosphate enemas.

Benefits and Risks

Benefit Summary

Sodium phosphate enemas are considered effective for treating constipation and bowel preparation before colonoscopies. 3 , 8

Risk Summary

Sodium phosphate enemas carry the risk of hyperphosphatemia, dehydration, and electrolyte abnormalities. These risks are amplified in elderly individuals, those with renal failure, heart failure, or liver dysfunction. 6 , 2 , 9

Comparison of Studies

Similarities between Studies

Numerous studies concur that sodium phosphate enema use is linked to potential risks like hyperphosphatemia. 6 , 2 , 9

Differences between Studies

Research investigating the safety and efficacy of sodium phosphate enemas exhibits variations in methodologies, target populations, and evaluation criteria. 3 highlights the effectiveness of sodium phosphate enemas for colonoscopy bowel preparation, whereas other studies suggest the existence of safer alternatives. 4

Consistency and Contradictions in Results

Studies investigating the safety and efficacy of sodium phosphate enemas haven't produced entirely consistent conclusions. While some studies indicate their effectiveness for bowel cleansing, others highlight the potential for severe metabolic complications. Decisions regarding sodium phosphate enema use should be carefully made, taking into account individual patient circumstances and risk factors.

Practical Implications and Precautions

While sodium phosphate enemas are effective for treating constipation and bowel preparation before colonoscopies, they also carry the risk of serious metabolic complications. It's crucial to weigh the benefits and risks carefully and discuss the potential issues with a healthcare professional before using sodium phosphate enemas. Patients should be fully aware of the potential risks and discuss their individual circumstances with their doctor.

Limitations of Current Research

Research on the safety and efficacy of sodium phosphate enemas remains limited. Notably, long-term usage studies are lacking. Further research is needed to comprehensively assess the safety of sodium phosphate enemas.

Directions for Future Research

Further research is necessary to gain a more thorough understanding of the safety and efficacy of sodium phosphate enemas. Specifically, the following areas require further investigation:

  • Long-term usage studies
  • Comparative studies with other bowel cleansing agents
  • Studies across diverse patient populations

Conclusion

Sodium phosphate enemas, while effective for treating constipation and bowel preparation for colonoscopies, carry the potential for serious metabolic complications. It's crucial to carefully assess patient circumstances, discuss the potential risks with a healthcare professional, and consider alternative bowel cleansing options when appropriate. Further research is required to gain a comprehensive understanding of the safety and efficacy of sodium phosphate enemas, particularly regarding long-term use.

Literature analysis of 16 papers
Positive Content
10
Neutral Content
1
Negative Content
5
Article Type
2
0
0
5
15
1.

Changes in the rectal mucosa induced by hypertonic enemas.

Author: LericheM, DevroedeG, SanchezG, RossanoJ

Diagnoses enema reaction
Identifies microscopic changes

The effects of hypertonic enemas on the rectal mucosa can be identified on biopsy, distinguishing them from the macroscopic appearance of quiescent ulcerative colitis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Serum electrolyte shifts following administration of sodium phosphates enema.

Author: JacobsonRobert M, PeeryJessica, ThompsonWilliam O, KanapkaJoseph A, CaswellMichael

Hyperphosphatemia
Sodium phosphate enema misuse

Sodium phosphate enemas are used to treat constipation. This study investigated the effects of using sodium phosphate enemas on blood levels of phosphate and sodium. The study found that sodium phosphate enemas can cause a temporary increase in blood phosphate levels, but this is not usually a problem unless the enema is used improperly or in someone with certain medical conditions.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department.

Author: HansenSarah E, WhitehillJordan L, GotoCollin S, QuinteroCheryl A, DarlingBrenda E, DavisJacqueline

Milk and molasses enemas (MME) were compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department. MME was found to be safe and effective, with a lower rate of side effects.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

Bowel preparation before colonoscopy. Choosing the best lavage regimen.

Author: ToosonJ D, GatesL K

Effective bowel cleansing
Side effects

This review article summarizes the findings of randomized trials comparing different bowel cleansing regimens for colonoscopy. Four recommended methods are: PEG-electrolyte solution with senna, PEG-electrolyte solution alone, oral sodium phosphate in split dose, and oral magnesium citrate with rectal pulsed irrigation. The authors suggest that clinicians should consider cleansing effectiveness, safety, patient tolerance, and cost when selecting a bowel cleansing regimen.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Fatal hyperphosphatemia from a phosphosoda bowel preparation.

Author: UllahNadeem, YehRobert, EhrinpreisMurray

Bowel preparation
Hyperphosphatemia
Ischemic colitis

This case report describes a patient who died as a result of severe hyperphosphatemia after an oral phosphosoda bowel preparation.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Drug labeling; sodium labeling for over-the-counter drugs. Final rule.

Author:

Electrolyte imbalance

The FDA has updated regulations for sodium labeling on over-the-counter rectal drug products containing sodium phosphates due to the risk of electrolyte imbalance.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Comparative studies on the usefulness of phosphate versus glycerin enema in preparation for colon examinations.

Author: SugimuraF, RyohH, WatanabeT, KanedaN, YonemitsuK, AokiT, MotokiY, KawamuraF, ArigaH, MatsuoY

Less abdominal pain
Delayed defecation
Rectal irritation

Phosphate enema and glycerin enema were found to be equally effective in preparing patients for colon examination, with no significant difference in colonic cleansing.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Acute hyperphosphatemia caused by sodium phosphate enema in a patient with liver dysfunction and chronic renal failure.

Author: Nir-PazR, CohenR, HavivY S

Hyperphosphatemia

A case of acute hyperphosphatemia secondary to rectal administration of sodium phosphate and sodium biphosphate (Fleet enema) was reported.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Colonoscopy preparation: are our patients at risk?

Author: ZuccaroGregory, ConnorJason T, SchreiberMartin

Safety concerns

Sodium phosphate colonoscopy preparation is a common method used for bowel cleansing prior to colonoscopy. While there have been concerns about the safety of this method, a review of relevant literature suggests that it is reasonable to follow the recommendations of the American Society of Colon and Rectal Surgeons, American Society for Gastrointestinal Endoscopy, and Society of American Gastrointestinal and Endoscopic Surgeons regarding sodium phosphate colonoscopy preparation.

EditorialAn article in which the editor or publisher expresses their opinion or perspective on a particular topic or issue. Its purpose is to convey a specific message or idea to the reader.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

11.

A novel phosphorus repletion strategy in a patient with duodenal perforation.

Author: KemmerlyThomas, VuongCarolyn, KaunitzJonathan D

Repletion of phosphate

This case report describes a patient receiving parenteral nutrition (PN) who developed hypophosphatemia. The authors successfully restored phosphate using diluted hypertonic sodium phosphate enemas, demonstrating a viable alternative for phosphate repletion in situations where parenteral supplements are unavailable.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

13.

The effects of sodium phosphate and polyethylene glycol-electrolyte bowel preparation solutions on 2,4,6-trinitrobenzenesulfonic acid-induced colitis in the rat.

Author: ErdoganBahattin, IsiksoySerap, DundarEmine, PasaogluOzgul, BalCengiz

Mucosal damage

Sodium phosphate (NaP) and polyethylene glycol-electrolyte (PEG-EL) colon cleansing solutions did not cause evident morphological changes on the rectal mucosa in rats with colitis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

14.

Mechanical bowel preparation for gynecologic laparoscopy: a prospective randomized trial of oral sodium phosphate solution vs single sodium phosphate enema.

Author: YangLinda C, ArdenDeborah, LeeTed T M, MansuriaSuketu M, BroachAmy N, D'AmbrosioLori, GuidoRichard

Surgical field quality
Adverse effects

This study found that both oral sodium phosphate solution and single sodium phosphate enema were equally effective in preparing the surgical field for advanced gynecologic laparoscopic procedures. However, patients who received the oral solution reported more adverse effects, including abdominal bloating, swelling, weakness, thirst, dizziness, nausea, fecal incontinence, and overall discomfort.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Bowel preparation before colonoscopy in the era of mass screening for colo-rectal cancer: a practical approach.

Author: ParenteF, MarinoB, CrostaC

Colo-rectal neoplasms detection
Electrolyte disturbances

This article discusses the importance of effective bowel cleansing before colonoscopy, given the increasing demand for colon cancer screening programs. Standard PEG solutions and sodium phosphate compounds are commonly used for bowel preparation, with NaP compounds being avoided in specific patient populations. Improved PEG formulations and patient education can increase compliance with bowel preparation and support colorectal cancer screening efforts.

Historical ArticleA research paper that analyzes past events and developments using primary sources and examines them from a historical perspective.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

The effect of povidone-iodine rectal cleansing on post-biopsy infectious complications.

Author: BostancıCoşkun, BozkurtUfuk

Biopsy safety

Povidone-iodine rectal cleansing seems to decrease infectious complications related to prostate biopsy procedure, but a randomized controlled trial is needed to confirm this.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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