View source for Whole bowel irrigation

==Indications<ref>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.</ref>==
*'''''LIMPS''' = '''L'''ithium, '''I'''ron, '''M'''etals, '''P'''ackers/stuffer, '''S'''ustained release drugs (especially beta-blockers, calcium channel blockers)
**[[Lithium overdose]] (extended-release tablets)
**[[iron toxicity|Iron]]
**[[heavy metal toxicity|Heavy metals]]
**Toxic ingestions of sustained- or delayed-release formulations
**Drugs carried by body packers
*Additional considerations:
**Agents that cause [[bezoar]] or concretion formation
**Paint chips containing [[lead]]
*Be mindful that the addition of PEG to activated charcoal significantly decreases activated charcoal's adsorptive capacity

==Contraindications==
*Preceding [[diarrhea]]
*Ingestion of substances expected to result in significant diarrhea (except [[heavy metals]])
*[[Bowel obstruction]] (as evidenced by lack of bowel sounds)
*avoid chilled solutions in neonates given risk for hypothermia

==Procedure==
*Give polyethylene glycol via NGT or PO (if tolerates) until rectal effluent is clear
**Adult: 1.5-2 L/hr
**Peds 6-12yr: 1 L/hr
**Peds <6yr: 0.5 L/hr
**Peds alt: 20-40 mL/kg/hr in young children

''Give [[ondansetron]] or [[metoclopramide]] as needed for [[nausea/vomiting]]''

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

==See Also==
*[[Toxicology (main)]]
*[[Gastric Lavage]]
*[[Activated charcoal]]
*[[Multidose Activated Charcoal (MDAC)]]

==External Links==
*[http://www.emdocs.net/toxcard-gi-decon/ emDocs - GI Decon]

==References==
<references/>

[[Category:Procedures]]
[[Category:Toxicology]]