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Related Experiment Video

Updated: May 22, 2026

Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation

Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation

Published on: March 14, 2017

Phosphate enemas causing profound refractory hypocalcaemia: A case report.

Jennifer Nobes¹, Michael J Murphy¹

¹Biochemical Medicine, Ninewells Hospital, Dundee, UK.

Annals of Clinical Biochemistry

|May 21, 2026

Summary

Phosphate enemas, used to treat hepatic encephalopathy in a patient with alcohol-related liver disease, caused severe hypocalcemia due to rectal phosphate absorption. Stopping the enemas corrected the electrolyte imbalance.

Keywords:

ALD Analytes Calcium Clinical studies Phosphate

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Last Updated: May 22, 2026

Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation

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Published on: March 14, 2017

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Area of Science:

Gastroenterology
Hepatology
Internal Medicine

Background:

Alcohol-related liver disease (ALD) can lead to decompensated cirrhosis and hepatic encephalopathy.
Hepatic encephalopathy management often involves reducing nitrogenous waste, including the use of enemas.
Electrolyte disturbances are common complications in patients with advanced liver disease.

Purpose of the Study:

To report a rare case of severe hypocalcemia and hyperphosphatemia.
To identify the cause of the electrolyte imbalance in a patient with decompensated cirrhosis.
To highlight a potential adverse effect of phosphate enemas in liver disease patients.

Main Methods:

A case report of a 37-year-old woman with alcohol-related liver disease and hepatic encephalopathy.
Monitoring of serum calcium and phosphate levels during treatment with phosphate enemas.
Clinical assessment and discontinuation of phosphate enemas based on laboratory findings.

Main Results:

The patient developed severe hypocalcemia (nadir 0.85 mmol/L) and hyperphosphatemia (6.4 mmol/L) after initiation of phosphate enemas.
Discontinuation of phosphate enemas led to normalization of serum phosphate within 72 hours.
Significant intravenous calcium supplementation was required to correct the hypocalcemia.

Conclusions:

Rectal absorption of phosphate from enemas can cause severe hypocalcemia in patients with decompensated cirrhosis.
Phosphate enemas should be used with caution in patients with liver disease due to the risk of electrolyte disturbances.
This case underscores the importance of vigilant electrolyte monitoring in patients receiving enema therapy.