Extreme hyperphosphatemia and hypocalcemic coma associated with phosphate enema

Heng Jung Hsu, Mai Szu Wu

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Fleet enema (sodium phosphate, C.B. Fleet Co., Inc., Lynchburg, Virginia) is widely used for bowel preparation or constipation relief in the hospital and over the counter. The potential risks, including hyperphosphatemia and hypocalcemic coma should be kept in mind of primary care physician. The patients with older age, bowel obstruction, small intestinal disorders, poor gut motility, and renal disease are contraindicated or should be administered with caution. We present a patient with old age and chronic renal failure who developed severe hyperphosphatemia and hypocalcemic tetany with coma after sodium phosphate enema. We recommend the use of alternative enema preparations, such as simple tap water or saline solution enemas, which can prevent fatal complications in high risk patients.

Original languageEnglish
Pages (from-to)643-646
Number of pages4
JournalInternal Medicine
Issue number7
Publication statusPublished - 2008
Externally publishedYes


  • Hyperphosphatemia
  • Hypocalcemia
  • Renal failure
  • Sodium phosphate enema

ASJC Scopus subject areas

  • Internal Medicine


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