Symptomatic hypocalcemia, hypomagnesemia, and hyperphosphatemia secondary to Fleet's phospho-soda colonoscopy preparation in a patient with a jejunoileal bypass

Sodium phosphate solutions (saline laxatives) are increasingly being prescribed for colonoscopy preparation due to their ease of use and improved patient compliance. Identification of patients at risk for complications of these preparations is ongoing. We report a case of a patient with a prior jejunoileal bypass surgery who developed symptomatic hypocalcemia, hypomagnesemia, and hyperphosphatemia after a single dose of Fleet's Phospho-Soda. The authors postulate that chronic malabsorption of calcium predisposed the patient to the development of the abnormalities. Caution is suggested in the use of this preparation in patients with small intestinal disorders.