Therapy

• Give sodium polystyrene sulphonate or calcium polystyrene sulphonate (calcium resonium) 30-60 g by mouth, combined with lactulose.^d
• Avoid using resins combined with sorbitol because of the rare complication of intestinal necrosis ^d
• If unable to give a resin by mouth or nasogastric tube, and there is no lower GI pathology absent, give as a retention enema.

Note:

• Give a cleansing enema, then 30 - 60 g sodium polystyrene sulphonate in enough tap water to make a slurry, and leave in situ for several hours or until evacuated (then use a tap-water enema to remove any residual slurry) ^d
• Rarely, sodium polysterene sulphonate use may be complicated by volume overload. ^d