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stomach pumping

Alternative Names 
gastric lavage, gastric suctioning

Definition
Stomach pumping is done to remove toxic substances that a person has accidentally or purposely swallowed.

Who is a candidate for the procedure? 
Anyone who has swallowed a poisonous substance or an overdose of drugs is a candidate for stomach pumping. A person's stomach may be pumped if he or she refuses to take medication to cause vomiting.

Sometimes a person should not vomit, if certain types of poisons have been swallowed. In these cases, the person's stomach may be pumped. Stomach pumping can also be used to collect a sample of the material that was ingested.

How is the procedure performed? 
Stomach pumping should be done as soon as possible after the person has swallowed the substance. This decreases the time the body is exposed to the poison. It also prevents drugs from being absorbed, if the person has taken an overdose.

If the person is unconscious or uncooperative, an endotracheal tube is inserted before the stomach is pumped. This is a tube that protects the airway, and prevents the person from breathing the stomach fluids into the lungs.

The person is placed on the left side, with the head lowered. A lubricated stomach tube is gently inserted through the mouth, into the oesophagus, and down to the stomach. The contents of the stomach are then suctioned out through the tube. The stomach can then be washed out with lukewarm water or salt water. This is done repeatedly until the fluids that come out of the stomach are clear.

Depending on what was swallowed, the person may be given activated charcoal after the stomach is pumped. The charcoal absorbs any drugs or poisons that may still be in the stomach. Activated charcoal can be given with a cathartic, which is a medication that speeds the emptying of the intestines.

What happens right after the procedure? 
After the stomach has been pumped, the person will be watched for any signs of toxic effects from the poison or overdose. The observation period depends on what was swallowed. It may involve monitoring in the hospital for 24 hours or longer.

If the overdose was intentional, the person needs to have one-on-one observation to prevent any further attempts at suicide. An evaluation by a psychiatrist will need to be done after the person recovers from the overdose.

Material removed from the stomach may be sent to the laboratory for analysis. The results may determine whether an antidote is needed or if the person should be monitored longer in the hospital.

What happens later at home? 
A person usually doesn't go home until after the period of dangerous side effects has passed. The person may have a sore throat for a day or two. If stomach pumping is done because of a poisoning, the home should be checked for poisons such as chemicals, cleansers, drugs, supplements, tobacco, and other toxic substances. These materials should be clearly marked and stored where children cannot get them.

What are the potential complications after the procedure? 
Stomach pumping can cause a person with a strong gag reflex to vomit. This can lead to aspiration, or breathing in the contents of the stomach. This can cause aspiration pneumonia. Nosebleeds may occur when the tube is inserted through the nose.

Author: William M. Boggs, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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