Don't be afraid of stomach pumping! Let's find out exactly what it is.

You've probably seen it in movies, when someone accidentally or for some other reason takes too many pills, they take them to the hospital and they put a tube in and drain the contents of their stomach. This is what we usually call 'stomach lavage' or 'stomach pumping'. Although it may seem a little scary, it is a very important medical procedure that can save a life. But is this something that is done all the time? How is it done? Does it hurt? Let's talk about this today, exactly, without any fear.

Simply put, what is gastric lavage?

Gastric lavage is the process of suctioning out the contents of your stomach (the contents of your stomach). This is medically called gastric lavage . 'Lavage' means 'washing'. So, in this process, two things actually happen. A doctor or a trained medical staff member inserts a tube into your stomach, flushes it with water or saline, and then sucks out the contents of your stomach with the liquid. This tube is usually passed through your nose (nasogastric tube) or through your mouth (orogastric tube) into your stomach.

Why is it necessary to wash one's stomach?

As most people know, this is done in an emergency. To be precise, if someone drinks poison, or takes an overdose of something like pills , this method is used to save life by quickly removing the poison from the stomach before it can be absorbed into the body.

For example:

• Some people experience a lot of pressure and discomfort in their stomachs due to food, liquids, or air. At those times, this method is used to relieve that pressure.
• If there is a lot of bleeding (hemorrhage) due to something like a stomach ulcer, this will also help to clean up and remove the excess blood.
• During major surgery, while under anesthesia, there is a high chance that the contents of the stomach will come back up into the throat and get stuck in the windpipe (aspiration). Imagine how dangerous that would be. To prevent such things, this method is also used to remove the fluids that accumulate in the stomach throughout the surgery.

Isn't gastric lavage so common these days in an emergency?

Yes, that story is true. Unlike in the past, not everyone who has ingested poison is now required to have their stomachs flushed. In recent decades, even the world's major toxicological societies have recommended that this should not be done routinely.

The reason for this is that in some cases, there are other methods that are safer and more effective than gastric lavage. For example, one method is to give activated charcoal . This is a black powder. When it enters the stomach, it absorbs the toxins in the stomach onto its surface. Then, along with the toxins, it is excreted in the stool. Another method is called Whole Bowel Irrigation . This involves giving a large amount of a special liquid and washing out the entire digestive tract. So, the doctor decides what the most appropriate treatment is based on many factors, such as the patient's condition, the type of toxin ingested, and how long it has been there.

Okay, so let's see how exactly this treatment works.

This entire process can be divided into three main steps.

1. Preparation

2. Intubation

3. Gastric Suctioning/Lavage

Preparation

Before starting this, the medical staff will first carefully monitor your vital signs, such as blood pressure, heart rate, and breathing rate . If you are conscious, they will explain the treatment to you and obtain your informed consent. They will check your gag reflex. Sometimes, a breathing tube may be inserted to help keep your airway open during this procedure.

Intubation

The tube used to wash the stomach can be inserted either through the nose (nasogastric tube) or through the mouth (orogastric tube), as mentioned earlier. To quickly empty the contents of the stomach, a slightly wider tube is usually used, which is inserted through the mouth.

Here's how to do this:

• First, you will be placed in a slightly upright position, or you will be placed on your back with your head slightly lowered and turned to the left.
• Then, a topical anesthetic spray is applied to the throat. This reduces discomfort such as nausea and sore throat.
• If you are using the mouthpiece, there is a small bite block inside your mouth to prevent you from accidentally chewing on the mouthpiece.
• Next, the doctor will measure and mark the length of the tube needed to reach your stomach.
• A lubricant is applied to the tip of the tube and passed very carefully down the throat.
• If you are conscious, you can ask for help swallowing the tube or ask for a drink of water through a straw.
• Once the tube is inserted to the marked size, it is secured to the skin with a plaster to prevent it from moving around.

Washing the stomach and removing fluids

Once the tube is firmly in the stomach, the rinsing process begins. This can be done with either plain water or a saline solution. Saline is used, especially for young children and those who are dehydrated from vomiting, to maintain the body's salt and electrolyte balance. Sometimes, an antidote appropriate for the type of poison ingested may be added to this solution.

• First, a small amount of liquid (about 300 mL for an adult, about 10 mL for a child) is sent through the tube into the stomach.
• After leaving it for about a minute or two, the liquid is drawn back out through the tube (suction).
• This process is repeated several times until the returning fluid is clean, meaning that almost all of the contents of the stomach have been removed.
• If necessary, activated charcoal is added to the final liquid. This will trap any remaining toxic particles in the stomach, allowing them to pass through the intestines and be eliminated with the stool.

Does it hurt a lot when you do this? How does it feel?

This is a problem that many people have. In fact, pumping doesn't hurt. However, having a tube in your throat can be uncomfortable. You may experience a sore throat, especially when inserting and removing the tube. However, doctors can help minimize this discomfort by using a numbing spray or lubricating the tube, which can be very manageable.

What are the risks and complications of this treatment?

If a trained doctor performs this procedure correctly, the risk of complications is very low. However, as with all medical procedures, there is a small risk.

• A small injury to the esophagus or stomach when the tube is inserted.
• If you vomit during treatment, the contents may enter your airway (aspiration) . This can be dangerous.
• The tube accidentally enters the airway. (That's why the exact location is confirmed)
• When the tube is in the throat, a nerve (vagus nerve) is stimulated, causing cardiac arrhythmias .

The chances of something like this happening are very low. However, the medical staff is always vigilant and takes necessary measures.

If poison is ingested, is it necessary to flush the stomach? How do you decide?

This is a very important question. Gastric lavage is most effective only if it is done early in the poisoning process. Over time, the poison will gradually begin to be absorbed into the body from the intestines. At that point, gastric lavage will not be of much use. Therefore, a doctor will consider several factors when deciding whether to perform this treatment.

How do you recognize an emergency? What are the signs that you should see a doctor immediately?

If you or someone you care for has overdosed on medication, ingested a poison, or is suffering from alcohol poisoning, seek medical advice immediately. Do not wait for symptoms to appear. If in doubt, take them to the nearest hospital Emergency Department (ETU) .

Here are some common symptoms of poisoning:

• Dizziness
• Nausea and vomiting
• Heart palpitations
• Difficulty breathing
• Burns inside or around the mouth
• Chemical smell on the breath
• Seizures
• Restlessness or agitation
• Loss of consciousness
• Severe drowsiness or loss of consciousness