A Case of SIADH After Bowel Preparation for Routine Colonoscopy

Authors

Joseph C. Rath, University of South Dakota Sanford School of MedicineFollow
Allison M. Hemmer, University of South Dakota Sanford School of MedicineFollow
Kennedy A. Forest, University of South Dakota Sanford School of MedicineFollow
Kahlen R. Morris, University of South Dakota Sanford School of MedicineFollow
Mary E. Watson, University of South Dakota Sanford School of Medicine; Center for Family Medicine, Sioux Falls Family Medicine ResidencyFollow

Abstract

Electrolyte abnormalities, including hyponatremia, are a known outcome of bowel preparations used for colonoscopy. Severe and symptomatic hyponatremia after bowel preparation is uncommon and occurs due to excessive release of ADH among other contributing factors. Risk factors for developing hyponatremia after bowel preparation include increased age, female gender, kidney disease, heart failure, and use of various medications. We present the case of a 78-year-old female who presented with altered mental status and possible seizures after completing bowel preparation with polyethylene glycol for a colonoscopy. Serum and urine studies were consistent with SIADH. She required fluid restriction, hypertonic saline, and sodium supplementation over several days to return her sodium levels and neurologic status to baseline. This case emphasizes that physicians should be aware of the potential for severe electrolyte abnormalities that may occur after oral bowel preparations in preparation for colonoscopy, especially in patients with multiple risk factors.

Recommended Citation

Rath JC, Hemmer AM, Forest KA, Morris KR, Watson ME. A Case of SIADH After Bowel Preparation for Routine Colonoscopy. Aesculapius. 2024 Dec 31; 5(1):Article 2. Available from: https://red.library.usd.edu/aesculapius/vol5/iss1/2. Free full text article.