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August 2, 1965

Potassium Chloride and Small Bowel Obstruction

JAMA. 1965;193(5):403. doi:10.1001/jama.1965.03090050079033

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To the Editor:—  In "Reversible Small-Bowel Obstruction," (Clinical Notes, JAMA192:781 [May 31] 1965) the authors present a case "to illustrate that the pathological changes are perhaps not irreversible and that the clinical course may be ameliorated by cessation of therapy without the necessity of surgical intervention."Enteric coated preparations of potassium chloride expose a significant number of patients to an unnecessary and serious risk. Animal studies have repeatedly confirmed that enteric coated potassium chloride usually combined with thiazide diuretics is responsible for ulcerations of the small-bowel.The natural history of these obstructing lesions of the small-bowel is not fully understood or thoroughly documented. Review of the cases of small-bowel ulceration and obstruction operated upon in Baltimore and elsewhere reveals a wide variation in the relationship of symptoms to medication. Patients who perforate have received the medication for a shorter period of time and are usually taking it at

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