Gastro-intestinal decontamination involves techniques to evacuate the stomach such as syrup of ipecac-induced emesis and gastric lavage. Charcoal, whole bowel irrigation and cathartics can also be used. All these techniques have various indications, contradictions and effects. Emesis is done by administering a syrup of ipecac, which is originally derived from plants.it has a direct impact on the stomach and stimulates the chemotactic trigger zone. Manual stimulation which is done by placing a finger at the throat and use of other emetics such as saline and hydrogen peroxide have been found to be harmful and not that effective. A dose of ipecac produces emesis within an average time of twenty minutes to vomit.
Gastric lavage uses a large bore tube and to properly perform this, the airway should be protected if the gag reflex is absent.it is done by placing the patient on his left lateral decubitus position with his head down and using suction to clear the secretions. Confirm the position of the tube and lavage with the desired quantities of fluid until it is clear.
On the other hand, activated charcoal is a black powder that is prepared by burning of carbonaceous products. Toxins are absorbed to the charcoal that is activated. The amount of charcoal used is directly proportional to the drugs to be absorbed. Although other toxins such as alcohols and strong acids are not well absorbed into the charcoal, this method is effective.
Cleansing the bowel has several benefits which will help flush out pollutants from the body that make one feel weak and in poor health. Decontaminating the colon involves re-organizing one’s feeding plan.it is always advisable to consult a doctor before beginning any kind of treatment plan. The purifying process involves a lot of fruit intake such as mangoes and melons.it is worth noting that melons should be taken on their own to avoid gas build up.
Dandelion can also stimulate colon contraction thereby enabling stools to move along. On the other hand, licorice tea helps in loosening of the bowels in cases of constipation and is ideal when taken before going to sleep.one can also cleanse the colon by taking oral supplements through the mouth or via the rectum. The idea is to expel toxins from the colon.
Colon irrigation is also common these days.it is done using a machine where a low pressure pump floods water through a tube inserted into one’s rectum. When the water settles in the colon, the therapist massages one’s abdomen enabling him or her to release the water as a normal bowel movement. Water removes wastes and the fluids. Mules who smuggle illicit drugs usually conceal them in different body parts such the rectum and vagina or even in the gastrointestinal tract. The drugs are usually packed in different materials such as condoms or plastic bags. Such drugs can be manually removed except when they have been ingested. Once in the gastro-intestinal tract, removal can be challenging, and perforations of the drug container can be fatal.
The use of sodium polystyrene sulfonate (SPS) has also been used in the treatment of lithium overdoses to prevent further absorption and potentially increase lithium elimination. The use of SPS for the treatment of hyperkalemia has been clinically widespread.
Use of Cathartics involves accelerating defecation as opposed to a laxative, which eases defecation, usually by softening feces. However, it is possible for a substance to be both a laxative and a cathartic.
Examples of Cathartics are sorbitol, magnesium citrate, magnesium sulfate and sodium sulfate. High-dose cathartics may be a good means of ridding the gastrointestinal tract of toxins even though they carry a risk of electrolyte imbalances and dehydration.
Emesis is mostly effective when pills cannot pass through the lavage tube.it is extremely useful in substances that cannot be absorbed by charcoal. However, it should not be used in late pregnancy, where sharp objects are involved, on someone who is in comatose or as a form of punishment. Emesis can also cause diarrhea, lethargy and abortion can be induced by ipecac.
Lavage on the other hand is preferred in patients with no gag reflexes. Should not be used if the airway cannot be protected and when the drug is not accessible in the stomach. During the procedure, there can be decreased oxygen or even gastric perforation.
Charcoal is ideal where there is a loss of reflexes in the protective airway and when endoscopy visualization is required.
Activated charcoal is superior to ipecac-induced emesis for removal of common drugs that are adsorbed to activated charcoal although it remains unclear whether ipecac is superior to gastric lavage for decontamination. However, other important considerations must be taken into account. Ipecac induced emesis can lead to the delay in the administration of activated charcoal or oral antidotes.it is also not appropriate for use in patients with unstable mental conditions. Lavage is not used in decontamination of small children.
Some pills that do not readily dissolve may not fit through the ports of a lavage tube.
Whole bowel irrigation could have complications such as Vomiting and frequently bloating occurs.at times, rectal irritation also happens.
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