Incidence of Hypokalemia After Low-Volume Bowel Preparation

Hypokalemia and other electrolyte disturbances can result from any of the commercially available or homemade bowel preparations for colonoscopy. In the current prospective study, a Dutch gastroenterology group evaluated the incidence of hypokalemia in high-risk patients (those using diuretics, hospitalized, or otherwise deemed at high risk) after bowel preparation with a 2-L polyethylene glycol–electrolyte solution with ascorbate. The stimulus for the study was the death of two patients from fatal cardiac arrhythmias shortly after colonoscopy.

First, potassium levels were measured before bowel preparation in 1822 patients, of whom 70 (3.8%) had mild hypokalemia (3.0–3.5 mmol/L), 7 (0.4%) had moderate hypokalemia (2.5–3.0 mmol/L), and none ha…