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Lower Gastrointestinal Bleeding Associated With Sodium Polystyrene Sulfonate Use
Eduardo Dantas1, Mariana Coelho1, Cristiana Sequeira1
1Gastroenterology Department, Centro Hospitalar de Setúbal, Setúbal, Portugal.
ACG Case Reports Journal
|May 17, 2021
Summary
Sodium polystyrene sulfonate (kayexalate) can cause serious gastrointestinal injury, including ulceration and perforation. This case highlights the rare but significant risks associated with this common hyperkalemia treatment.
Area of Science:
- Gastroenterology
- Nephrology
- Internal Medicine
Background:
- Sodium polystyrene sulfonate (SPS), a cation-exchange resin, is frequently prescribed for managing hyperkalemia.
- While generally safe, SPS can rarely lead to gastrointestinal complications.
Observation:
- An 81-year-old male with cirrhosis, acute kidney injury, and hyperkalemia was treated with SPS.
- The patient experienced hematochezia, tachycardia, and a significant drop in hemoglobin during hospitalization.
Findings:
- Colonoscopy identified colonic ulcerations.
- Histopathological analysis confirmed the ulcerations were consistent with kayexalate-induced injury.
Implications:
- This case underscores the potential for severe gastrointestinal adverse events from sodium polystyrene sulfonate.
- Healthcare providers should maintain awareness of these rare but serious complications, even with widespread use.
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