Whole bowel irrigation: Difference between revisions

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==Complications==
==Complications==
*Bloating, cramping, rectal irritation (from frequent bowel movements)
*Bloating
*Cramping
*Rectal irritation (from frequent bowel movements)


==See Also==
==See Also==

Revision as of 14:34, 25 August 2015

Indications[1]

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

Contraindications

  • Preceding diarrhea
  • Ingestion of substances expected to result in significant diarrhea (except heavy metals)
  • 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

Polyethylene glycol dosing

Can be given orally or by NG tube

  • 20-40 mL/kg/hr in young children
  • 2L/hr in adults

Continue irrigation until the rectal effluent is clear

Complications

  • 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.