Richard J. Burnett, PharmD
To the Editor: In the report by Wootton and colleagues (1) describing colonic necrosis in a renal transplant recipient after receiving a sodium polystyrene sulfonate suspension (SPSS) in a sorbitol enema, the authors referenced an article by Lillemoe and colleagues (2) describing other similar case reports and a small study in rats showing colonic damage after instillation of SPSS in sorbitol enemas. The package insert (3) for SPSS recommends and highlights in bold letters that, if the product is to be used as an enema, after instillation and retention of SPSS, the colon then be irrigated with a nonsodium-containing solution
Burnett RJ. Sodium Polystyrene-Sorbitol Enemas. Ann Intern Med. ;112:311–312. doi: 10.7326/0003-4819-112-4-311_2
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Published: Ann Intern Med. 1990;112(4):311-312.
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