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Canadian Journal of Gastroenterology
Volume 18, Issue 7, Pages 455-458
Brief Communication

Recognizing the Clinical Contraindications to the Use of Oral Sodium Phosphate for Colon Cleansing: A Case Study

Lawrence C Hookey and Stephen Vanner

Gastrointestinal Diseases Research Unit, Division of Gastroenterology, Hotel Dieu Hospital, Queen’s University, Kingston, Ontario, Canada

Received 21 January 2004; Accepted 18 May 2004

Copyright © 2004 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Oral sodium phosphate has been demonstrated in numerous clinical trials to be an effective and well-tolerated colonic cleansing agent. However, there exists a potential to induce shifts in intravascular volume. The phosphate load often results in hyperphosphatemia, which may precipitate hypocalcemia. A review at the authors' institution identified four patients with adverse events related to oral sodium phosphate. Three of these cases had pre-existing comorbidities that predisposed them to the adverse event, or had received doses higher than that used or recommended in previous trials. Recommendations for relative and absolute contraindications to the use of oral sodium phosphate are described.