Colonoscopy Prep Protocol for Patient with Hypokalemic Periodic Paralysis

The regular colonoscopy prep can cause a hypokalemic episode in a patient with hypokalemic periodic paralysis. This colonoscopy prep, adapted to avoid hypokalemia, has been used by numerous patients with HypoKPP on the HKPP Listserv without provoking an episode afterwards. 

Colonoscopy Prep:

Day 1 Normal diet with an herbal tea laxative before bed.

Day 2 No solid foods, milk products or liquids with red or purple coloring; Suggested liquids are low sodium chicken stock, tea without milk, and water throughout the day.

4:00 pm: 20 mEq liquid potassium supplement with 10 oz. of water.

5:00 pm: two 5 mg Dulcolax biscolyl tablets.

7:00 pm: Four doses of Miralax (17 grams each) mixed with 8 oz. of water; with fifteen minutes between each dose. Dose #3 mixed with 20mEq of liquid potassium. The doctor's instructions (for normal people) was to mix doses 3 and 4 with Gatorade or Smart Water.

Day 3

1:00 am: repeated the four doses of Mirilax as described above.

4:00 am: no more liquids.

10:00 am: colonoscopy.

For fluids Ringers Lactate IV which contains 5 mEq of potassium.

Anesthesia used most often is midazolam (versed) though some use diprivan (propofol).

Disclaimer This information is based on the experience of a number of patients who have used it successfully with the guidance of their physician.

 

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