Gastrointestinal decontamination refers to the practice of functionally removing an ingested toxin from the gastrointestinal (GI) tract in order to decrease its absorption. When a patient attends hospital after ingestion of a toxin one of the first considerations is whether anything can be done to prevent or reduce absorption. Gastric decontamination has been a cornerstone in the management of overdose for decades.
Historically, many approaches have been adopted, including gastric evacuation (forced emesis or gastric lavage), intra-gastric binding (most commonly by single or multidose activated charcoal), or speeding transit of toxins to decrease total absorption time (whole bowel irrigation or cathartics). As clinical practice has evolved and understanding of the efficacy, risks, and benefits of decontamination have grown, many practices have fallen out of favor.
This topic covers: Emesis, Gastric lavage, Catharsis, Activated charcoal, Whole bowel irrigation