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Year : 2015  |  Volume : 1  |  Issue : 1  |  Page : 21-26

Scrutinizing the evidence linking hypokalemia and ileus: A commentary on fact and dogma

1 Department of General Surgery, University of Illinois at Mt. Sinai Hospital, Columbus, USA
2 Department of Surgery, Division of Trauma, Critical Care, and Burn, Ohio State University Wexner Medical Center, Columbus, USA

Correspondence Address:
William Matthew Brigode
Department of General Surgery, University of Illinois at Mt. Sinai Hospital, 1500 South Fairfield Avenue, Chicago, Illinois 60608
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Source of Support: None, Conflict of Interest: None

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Low serum potassium has been linked to classic signs and symptoms including mental status changes, muscular dysfunction and paralysis, and cardiac arrhythmias. Frequently, it has been listed as a cause for paralytic ileus, and correcting electrolyte anomalies is one of the first steps in treatment of a patient with nonfunctioning bowels. However, our review of the literature does not support a clear causative link. Older studies cite potassium as one of the many factors to optimize to regain bowl function, while newer studies do not support hypokalemia as a cause of ileus. Current treatment of ileus supports focusing on reversal of the effect of opiates on the gut, while electrolyte therapeutic goals are directed to prevent complications outside of the gastrointestinal (GI) tract. We review the cellular physiology and clinical data to elucidate the nature of the link between low potassium values and its impact on GI motility. Patients: Patients with hypokalemia and ileus. Intervention: Potassium repletion. Comparison: Patients with normal potassium values. Outcomes: Resolution of ileus. Population, intervention, comparator, and outcomes questions: Does low serum potassium cause intestinal ileus, and will correction of this deficit correct the intestinal paralysis?. The following core competencies are addressed in this article: Practice-based learning and improvement of medical knowledge. This article addresses the evidence linking hypokalemia and ileus to improve medical knowledge and enable physicians to put this evidence into practice.

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