We often see in movies and TV dramas that when someone drinks poison or takes a lot of pills, they are taken to the hospital and a 'stomach wash' is done. They insert a tube and take out the contents of the stomach. Actually, this is what we medically call 'Gastric Lavage' or 'Stomach Pumping'. Simply put, washing the stomach. But is this as simple as it seems in the movies? Is this done in every case of poisoning? Let's talk about this today.
What exactly is Gastric Lavage?
Simply put, this is a medical procedure in which the contents of your stomach are removed using a tube. This involves inserting a thin tube through your nose or mouth into your stomach, passing small amounts of water or saline solution through it, and then suctioning out the contents of your stomach with the liquid. This means that the stomach is being washed and cleaned, while at the same time removing the contents.
In what situations is a 'Stomach Pump' necessary?
Many people know this as an emergency treatment. Yes, it's true. Whether someone drinks poison or takes an overdose of medication , this method is used to save a life by removing the poison from the stomach before it can be absorbed into the body.
But this treatment is used not only for such emergencies, but also for other reasons.
- Reduce the pressure in the stomach when it is full of food, liquid, or air.
- Clean up excessive bleeding in the stomach.
- Empty and cleanse your stomach before major surgery. This can help prevent stomach contents from going up your throat during surgery.
| Situations where gastric lavage may be necessary | Medical procedures using gastric lavage |
|---|---|
| Toxic ingestion/Poisoning | Gastrointestinal surgery |
| Conditions that delay stomach emptying (Gastroparesis) | Assisted ventilation |
| Small bowel obstruction | Stomach acid test |
| Persistent nausea and vomiting | Before an endoscopy (Upper Endoscopy) |
| Bleeding in the upper digestive tract |
Is gastric lavage common in emergencies now?
To be honest, it's not as common as it used to be. Especially as a treatment for poisoning. Recently, the world's leading toxicology associations have recommended that gastric lavage not be the only treatment for all poisonings, but that other treatments be considered. In some cases, treatments such as activated charcoal can be safer and more effective. Therefore, doctors determine the most appropriate treatment based on many factors, including the patient's condition, the type of poison ingested, and the time that has passed.
How exactly does this treatment work?
This process can be divided into three main parts.
1. Preparation: When you arrive at the hospital, doctors and nursing staff will regularly check your vital signs - such as your heart rate, blood pressure, and breathing rate. If you are conscious, they will explain the procedure and obtain your consent. If necessary, a breathing tube may be inserted to prevent stomach contents from going into your lungs during the procedure.
2. Intubation: This involves inserting a tube into your stomach and connecting it to a pump outside. If this tube is inserted through your nose, it is called a ``nasogastric tube'', and if it is inserted through your mouth, it is called an ``orogastric tube.'' A slightly wider tube, which is inserted through your mouth, is often used to wash your stomach.
- This can be done by either lying down straight or turning to the left and lowering your head slightly.
- I spray a medicine to numb my throat. This greatly reduces the soreness and discomfort.
- There is a small bite block in the mouth to prevent chewing on the tube.
- Measure the length of the tube you need for your stomach and mark it.
- The tip of the tube is lubricated with a good amount of lubricant and slowly passed down your throat into your stomach. If you are conscious at this time, you will be asked to drink some water. This will help the tube go in more easily.
- To be 100% sure that the tube is in the stomach, an X-ray is performed, or a small sample of fluid is taken from the tube and its pH is checked.
3. Gastric Suctioning/Lavage: After confirming that the tube is in place, a small amount of liquid (water or saline) is passed through the tube into the stomach. After a minute or two, the liquid is then withdrawn along with the contents of the stomach. This is done several times until the liquid that comes back is completely clean. Sometimes, activated charcoal is added to the final liquid. This helps to trap any remaining toxins that have entered the intestines and flush them out with the stool.
Does it hurt when you do this? To be honest, there may be a slight discomfort and a feeling of something coming down your throat when you put the tube in and take it out. But the medical staff does their best to minimize that. There is no pain when the things are taken out of the stomach.
When should you decide to flush the stomach in case of poisoning?
This is very important. This does not work for every poisoning. The doctor makes this decision after considering several factors.
| Making decisions about stomach pumping | |
|---|---|
| This treatment is often used when: | |
| If the poison has not been ingested for a long time (usually within an hour). | |
| If the poison ingested is of a very severe, life-threatening type. | |
| If other treatments (such as Activated Charcoal) are insufficient or cannot be given. | |
| Situations where this treatment is not appropriate or may be risky: | |
| When substances that cause inflammation (e.g. acid, kerosene) are ingested. (The damage may increase if the tube is inserted). | |
| If the patient is unconscious or unconscious (without securing the airway). | |
| If the patient is having a seizure (fit) . | |
| If several hours have passed since the poison was ingested (because the poison has already been absorbed by then). |
When to seek immediate medical advice
If you or someone you care for suspects a drug overdose, poison ingestion, or alcohol poisoning, you should seek immediate medical attention without delay . Be on the lookout for the following symptoms:
Most importantly: Never try to induce vomiting or other treatments at home. Medical advice is essential. If in doubt, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.
| Emergency warning signs of poisoning | |
|---|---|
| Dizziness | Nausea and vomiting |
| Heart palpitations | Difficulty breathing |
| Burns in and around the mouth | Chemical smell on the breath |
| Seizures | Restlessness |
| Drowsiness or loss of consciousness | Mental confusion |
| If you have these symptoms, go to the nearest Emergency Department (ETU) immediately! | |
Take-Home Message
- 'Stomach Pumping' is not as simple as it is shown in movies, it is a treatment performed by trained personnel for specific medical reasons.
- This treatment is mainly used in cases of severe poisoning (within a short time of its occurrence) and for other medical needs.
- Gastric lavage is not appropriate for every poisoning. Your doctor will determine the most appropriate and safest treatment for the patient.
- If there is even the slightest suspicion of poisoning, do not attempt to treat it at home, but immediately go to a hospital's Emergency Treatment Unit (ETU).
- If you have any concerns or questions about this, don't be afraid to talk openly with your doctor.
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