Whole bowel irrigation: Difference between revisions

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#Iron and other heavy metals
#Iron and other heavy metals
#Paint chips containing [[Lead]]
#Paint chips containing [[Lead]]
#Lithium overdose (extended-release tablets)
#[[Lithium overdose]] (extended-release tablets)
#Drugs carried by body packers
#Drugs carried by body packers



Revision as of 01:56, 22 June 2015

Indications[1]

  1. Sustained or delayed-release formulations
  2. Agents with potential for bezoar formation
  3. Iron and other heavy metals
  4. Paint chips containing Lead
  5. Lithium overdose (extended-release tablets)
  6. Drugs carried by body packers

Contraindications

  1. Preceding diarrhea
  2. Ingestion of substances expected to result in significant diarrhea (except heavy metals)
  3. Bowel obstruction (as evidenced by lack of bowel sounds)

Procedure

  • Give polyethylene glycol via NGT or PO (if pt tolerates) until rectal effluent is clear
    • Adult: 1.5-2 L/hr
    • Peds 6-12yr: 1 L/hr
    • Peds <6yr: 0.5 L/hr
  • Give ondansetron or metoclopramide as needed for N/V

Complications

  1. Bloating, cramping, rectal irritation (from frequent bowel movements)

See Also

References

  1. Thanacoody, R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol. 2015; 53(1):5-12. doi: 10.3109/15563650.2014.989326.