Side Effects of sodium phosphate: A Synthesis of Findings from 29 Studies

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Original Abstract of the Article

Main research findings

Sodium phosphate is a common bowel preparation agent used before colonoscopy. While effective in cleansing the bowel, sodium phosphate has been associated with certain side effects. Sodium phosphate works by drawing water into the intestines, softening stool and promoting bowel movements. 11 However, studies have indicated that sodium phosphate can lead to electrolyte imbalances, such as elevated phosphate levels (hyperphosphatemia), low calcium levels (hypocalcemia), and acidosis, which can potentially cause health complications. 20 Furthermore, sodium phosphate can burden the kidneys, potentially exacerbating existing kidney issues. 10 Additional side effects reported include digestive issues like nausea, vomiting, abdominal pain, and diarrhea. 1 The appropriate dose of sodium phosphate varies depending on the patient's age, weight, and kidney function. It's essential for healthcare professionals to carefully assess these factors and determine a safe dosage. It's also crucial for patients to be aware of potential side effects and seek medical advice if necessary.

Reasons for side effects

Sodium phosphate works by drawing water into the intestines, softening stool and promoting bowel movements. This occurs because sodium phosphate increases the osmotic pressure in the intestines. However, this influx of water can disrupt the body's electrolyte balance, leading to electrolyte imbalances like hyperphosphatemia, hypocalcemia, and acidosis. Additionally, the increased burden on the kidneys due to sodium phosphate can contribute to the worsening of kidney disease. The stimulation of the intestinal lining by sodium phosphate can also cause gastrointestinal side effects like nausea, vomiting, abdominal pain, and diarrhea.

Common side effects

Hyperphosphatemia

Sodium phosphate, by drawing water into the intestines, can disrupt the body's electrolyte balance. This can lead to hyperphosphatemia, which is an elevated level of phosphate in the blood. 20 Hyperphosphatemia can contribute to health problems like kidney disease, heart disease, and osteoporosis.

Hypocalcemia

The disruption of electrolyte balance caused by sodium phosphate can also lead to hypocalcemia, a condition characterized by low calcium levels in the blood. 20 Hypocalcemia can manifest as muscle cramps, bone pain, and cardiac arrhythmias.

Acidosis

Sodium phosphate's action of drawing water into the intestines can disrupt the body's electrolyte balance, potentially resulting in acidosis, a condition of increased acidity in the blood. 20 Acidosis can lead to health problems such as shortness of breath, dizziness, and decreased consciousness.

Kidney burden

Sodium phosphate places a significant burden on the kidneys, potentially worsening existing kidney conditions. 10 Sodium phosphate can hinder kidney function, potentially leading to the worsening of kidney disease and, in severe cases, necessitate dialysis.

Gastrointestinal side effects

Sodium phosphate can cause gastrointestinal side effects, including nausea, vomiting, abdominal pain, and diarrhea. 1 These side effects are attributed to the stimulation of the intestinal lining by sodium phosphate. The severity of these gastrointestinal side effects can vary depending on the dosage and administration method of sodium phosphate.

Countermeasures for side effects

Countermeasures for hyperphosphatemia

Managing hyperphosphatemia involves limiting dietary phosphate intake and potentially taking medications that help eliminate phosphate from the body.

Countermeasures for hypocalcemia

Countermeasures for hypocalcemia include increasing calcium intake and potentially taking medications that facilitate calcium absorption.

Countermeasures for acidosis

Managing acidosis involves taking alkaline medications and potentially avoiding acidic foods.

Countermeasures for kidney burden

To minimize kidney burden, reducing the dosage of sodium phosphate or opting for alternative bowel cleansers may be considered.

Countermeasures for gastrointestinal side effects

Reducing the dosage of sodium phosphate or opting for alternative bowel cleansers can help reduce gastrointestinal side effects.

Comparison between studies

Common points of research

Numerous studies confirm that sodium phosphate is effective in cleansing the bowel prior to colonoscopy. 11 However, not all studies definitively conclude that sodium phosphate is a completely safe option.

Differences in research

The side effects associated with sodium phosphate vary between studies. Some studies indicate that sodium phosphate can lead to electrolyte imbalances, including hyperphosphatemia, hypocalcemia, and acidosis. 20 Other studies highlight sodium phosphate's potential to burden the kidneys and exacerbate existing kidney disease. 10 Factors such as patient age, weight, and kidney function can influence the likelihood and severity of side effects.

Precautions for applying to real life

While sodium phosphate is effective for bowel cleansing before colonoscopy, it's essential to be aware of the associated side effects. When considering the use of sodium phosphate, it's important to weigh the risks and benefits carefully and consult with a healthcare professional.

Limitations of current research

Research on the side effects of sodium phosphate remains limited. Specifically, there's a lack of robust studies investigating the long-term impact of sodium phosphate.

Future research directions

Further research is needed to understand the long-term effects of sodium phosphate. Additionally, research focused on developing new methods to mitigate sodium phosphate's side effects is crucial.

Conclusion

Sodium phosphate is an effective bowel cleansing agent used before colonoscopy, but it's important to be aware of the potential side effects. When considering its use, a careful assessment of risks and benefits is essential, and consulting with a healthcare professional is recommended. Research on the long-term effects of sodium phosphate and exploring alternative solutions to minimize its side effects are critical areas for future research.

Literature analysis of 29 papers
Positive Content
23
Neutral Content
2
Negative Content
4
Article Type
9
1
2
4
29
1.

Systematic review: the adverse effects of sodium phosphate enema.

Author: MendozaJ, LegidoJ, RubioS, GisbertJ P

Water and electrolyte disturbances

The main side effects of sodium phosphate enemas are water and electrolyte disturbances. The main risk factors are extreme age and associated comorbidity.

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.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Kinetics of hydrocortisone sodium phosphate penetration into the human aqueous humor after topical application.

Author: CaginiCarlo, MuziAlessio, CastellucciGreta, RagnaGiulia, LupidiMarco, AlabedHusam B R, PellegrinoRoberto Maria

Ocular treatment

This study investigated the anterior chamber penetration capabilities of hydrocortisone when used as eye drops treatment. The study aims to elucidate the pharmacokinetics of hydrocortisone in the eye.

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

10.

Efficacy and safety of sodium phosphate for colon cleansing in type 2 diabetes mellitus.

Author: OzturkNevin Akcaer, GokturkHuseyin Savas, DemirMehmet, UnlerGulhan Kanat, GurGurden, YilmazUgur

This study evaluated the efficacy, safety, and tolerability of sodium phosphate (NaP), and the quality of bowel cleansing in relation to glycemic control and late complications in diabetic patients.

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.

Language : English

11.

Comparison of standard polyethylene glycol and two doses of oral sodium phosphate solution in precolonoscopy bowel preparation: a randomized controlled trial.

Author: PicchioM, GallinaroL, CeciF, GammardellaP, CalìB, RebonatoA, StagnittiF

Improved colon cleansing
Reduced side effects
Nausea

Two doses of sodium phosphate solution taken 24 h and 12 h before colonoscopy were more effective in colonic cleansing than standard 4-liters polyethylene glycol solution and had less side effects.

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

12.

Split-Dose Preparations Are Superior to Day-Before Bowel Cleansing Regimens: A Meta-analysis.

Author: MartelMyriam, BarkunAlan N, MenardCharles, RestelliniSophie, KheradOmar, VanasseAlain

Effective colon prep

A meta-analysis of different colon preparation regimens for colonoscopy revealed that split-dose regimens are effective compared to other approaches. The study also aimed to identify the optimal products and volumes for successful bowel preparation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

13.

Improving quality of colonoscopy by adding simethicone to sodium phosphate bowel preparation.

Author: TongprasertSasinee, SobhonslidsukAbhasnee, RattanasiriSasivimol

Colonoscopy visibility
Patient satisfaction

This study found that adding simethicone to sodium phosphate bowel preparation significantly improved colonoscopy visibility by diminishing air bubbles. Endoscopist and patient satisfaction were also increased, but there was no difference in the total duration of the procedure or side effects.

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.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Oral sodium phosphate (Fleet) is a superior colonoscopy preparation to Picopre (sodium picosulfate-based preparation).

Author: TjandraJoe J, ChanMiranda, TagkalidisPeter P

Small volume bowel prep

This study compared the efficacy and tolerability of oral sodium phosphate and Picoprep for bowel preparation before colonoscopy.

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.

A Comparison of the Efficacy of Enema Solutions in Pediatric Emergency Department Patients.

Author: AndersonJulie, FurnivalRonald A, ZhangLei, LunosScott A, SadiqZujaja, StruttJonathan R, KailaRahul, HendricksonMarissa A

Abdominal pain

Sodium phosphate, soap suds, and pink lady enemas produced no significant differences in stool output in children treated in an emergency department. Soap suds had a significantly higher rate of side effects, primarily abdominal pain. Further research is needed to determine the optimal enema solution for children.

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

Language : English

16.

Colonic preparation before colonoscopy in constipated and non-constipated patients: a randomized study.

Author: PereyraLisandro, CimminoDaniel, González MallaCarlos, LaporteMariano, RotholtzNicolás, PeczanCarlos, LencinasSandra, PedreiraSilvia, CatalanoHugo, BoerrLuis

Improved colonic cleansing
Adverse effects

Sodium phosphate (NaP) preparations, especially a half-dose with bisacodyl, had higher compliance than polyethylene glycol (PEG) preparations for colonic cleansing. In non-constipated patients, NaP preparations were more effective and better tolerated. However, in constipated patients, the combination of NaP plus bisacodyl was the most effective preparation.

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

17.

Comparative study of two bowel preparation regimens for colonoscopy: senna tablets vs sodium phosphate solution.

Author: KositchaiwatSavit, SuwanthanmmaWeerapat, SuvikapakornkulRonnarat, TiewthanomVaewvadee, RerkpatanakitPrisna, TinkornrusmeeChaowalitr

Better taste
Fewer side effects

Senna tablets were found to be less effective than sodium phosphate solution in preparing the bowel for colonoscopy. However, senna was more tolerable with fewer side effects.

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

18.

A prospective study comparing oral sodium phosphate solution to a bowel cleansing preparation with nutrition food package in children.

Author: El-BabaMohammad F, PadillaMary, HoustonCarmela, MadaniShailender, LinChuan-Hao, ThomasRonald, ToliaVasundhara

Bowel cleansing
Colonoscopy preparation

This study compared the safety, efficacy, and patient acceptance of a prepackaged diet kit plus a magnesium citrate/bisacodyl bowel cleansing regimen with a clear liquid diet and sodium phosphate solution regimen in children undergoing colonoscopy.

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

19.

Observational study on the palatability and tolerability of oral prednisolone and oral dexamethasone in children in Saudi Arabia and the UK.

Author: AljebabFahad, AlanaziMofadhi, ChoonaraImti, ConroySharon

Nausea
Vomiting

Dexamethasone sodium phosphate solution was the most palatable preparation. Prednisolone base tablets were rated least palatable and were least well tolerated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

[Acute hyperphosphatemia secondary to phosphate administration for bowel preparation].

Author: GutiérrezE, GonzálezE, HernándezE, HerreroJ C, ManzaneraM J, GarcíaJ A, Domínguez-GilB, PragaM

Acidemia
Hyperphosphatemia
Hypocalcemia

This case report describes a 75-year-old woman on hemodialysis who developed acute hyperphosphatemia after receiving phosphate administration for bowel preparation. The patient's condition was successfully treated with intensive hemodialysis. This highlights the importance of considering renal function when administering phosphate cathartics.

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.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

21.

Antitumor activity and tumor localization of liposomal glucocorticoids in B16 melanoma-bearing mice.

Author: BanciuManuela, FensMarcel H A M, StormGert, SchiffelersRaymond M

Tumor growth inhibition
Side effects

Encapsulating glucocorticoids, a type of steroid medication, in long-circulating liposomes can make them more effective in fighting cancer and reduce the risk of side effects. Liposomes are tiny bubbles that can deliver medication directly to tumors, potentially increasing effectiveness and reducing side effects.

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

22.

[Safety and usefulness of the long-term intranasal topical treatment with steroids for olfactory dysfunction].

Author: KobayashiMasayoshi, ImanishiYoshinori, IshikawaMasako, NishidaKohei, AdachiMitsuo, OishiMaaya, NakamuraSatoshi, SakaidaHiroshi, MajimaYuichi

Olfactory dysfunction treatment
Steroid side effects

This study examined the side effects of intranasal topical treatment with betamethasone sodium phosphate in patients with olfactory dysfunction. While some patients experienced minor side effects, the treatment was generally well-tolerated and effective in improving olfactory dysfunction.

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 : Japanese

23.

The Use of Mechanical Bowel Preparation in Pelvic Reconstructive Surgery: A Randomized Controlled Trial.

Author: AdelowoAmos O, HackerMichele R, ModestAnna M, ApostolisCosta A, DisciulloAnthony J, HanawayKatherine J, ElkadryEman E, RosenblattPeter L, RogersKathleen J, HotaLekha S

Improved surgical field
Patient discomfort

Mechanical bowel preparation (MBP) using oral magnesium citrate before minimally invasive pelvic reconstructive surgery in 153 women provided an initial improvement in surgical field quality compared to sodium phosphate enema alone. However, the benefit was not sustained, and MBP was associated with increased patient discomfort.

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.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

A randomized controlled trial comparing the efficacy and acceptability of phospo-soda buffered saline (Fleet) with sodium picosulphate/magnesium citrate (Picoprep) in the preparation of patients for colonoscopy.

Author: RenautA J, RanigaS, FrizelleF A, PerryR E, GuilfordL

Colonoscopy preparation
Side effects

This randomized controlled trial compared the efficacy of two small-volume bowel preparations, Fleet and Picoprep, for colonoscopy. Both were effective, but Fleet was better tolerated by 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

26.

Systematic review: the adverse effects of sodium phosphate enema.

Author: MendozaJ, LegidoJ, RubioS, GisbertJ P

Water and electrolyte disturbances

The main side effects of sodium phosphate enemas are water and electrolyte disturbances. The main risk factors are extreme age and associated comorbidity.

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.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Intra-erythrocyte infusion of dexamethasone reduces neurological symptoms in ataxia teleangiectasia patients: results of a phase 2 trial.

Author: ChessaLuciana, LeuzziVincenzo, PlebaniAlessandro, SoresinaAnnarosa, MicheliRoberto, D'AgnanoDaniela, VenturiTullia, MolinaroAnna, FazziElisa, MariniMirella, Ferremi LealiPierino, QuintiIsabella, CavaliereFilomena Monica, GirelliGabriella, PietrograndeMaria Cristina, FinocchiAndrea, TabolliStefano, AbeniDamiano, MagnaniMauro

Improved adaptive behavior
Improved neurological symptoms

Ataxia-telangiectasia (AT) is a neurodegenerative disease with no available therapies. EryDex, a slow-release dexamethasone encapsulated in erythrocytes, showed potential benefits in improving neurological symptoms and adaptive behavior of AT patients.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
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

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