# Gastric lavage

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Process of clearing the stomach contents

**Gastric lavage**, also commonly called **stomach pumping** or **gastric washing** or **gastric suction**, is the process of cleaning out the contents of the [stomach](/source/Stomach) using a tube. Since its first recorded use in the early 19th century, it has become one of the most routine means of eliminating poisons from the stomach.[1] Such devices are normally used on a person who has ingested a [poison](/source/Poison) or [overdosed](/source/Drug_overdose) on a [drug](/source/Psychoactive_drug) such as [ethanol](/source/Ethanol). They may also be used before [surgery](/source/Surgery), to clear the contents of the [digestive tract](/source/Digestive_tract) before it is opened.

Apart from toxicology, gastric lavage (or nasogastric lavage) is sometimes used to confirm levels of bleeding from the upper gastrointestinal tract.[2] It may play a role in the evaluation of [hematemesis](/source/Hematemesis). It can also be used as a cooling technique for [hyperthermic](/source/Hyperthermia) patients.[3]

## Technique

Gastric lavage involves the passage of a tube (such as an *Ewald tube*) [via the mouth or nose](/source/Nasogastric_intubation) down into the stomach followed by sequential administration and removal of small volumes of liquid. The placement of the tube in the stomach must be confirmed by pH testing a small amount of aspirated stomach contents, or x-ray. This is to ensure the tube is not in the lungs.

In adults, small amounts of warm water or saline are administered and, via a siphoning action, removed again. In children, [normal saline](/source/Saline_(medicine)) is used, as children are more at risk of developing [hyponatremia](/source/Hyponatremia) if lavaged with water. Because of the possibility of vomiting, a suction device is always on hand in case of [pulmonary aspiration](/source/Pulmonary_aspiration) of stomach contents. Lavage is repeated until the returning fluid shows no further gastric contents.

If the patient is unconscious or cannot protect their airway then the patient should be [intubated](/source/Intubation) before performing lavage.[*[according to whom?](https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Words_to_watch#Unsupported_attributions)*] The person must be anaesthetised for a period of time during the operation due to its high risk of shock and [hyponatremia](/source/Hyponatremia).[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

### Indications

Gastric lavage is used infrequently in modern poisoning treatment. Some authorities have actually suggested that it not be used routinely, if ever, in poisoning situations.[4] Lavage should only be considered if the amount of poison ingested is potentially life-threatening and the procedure can be performed within 60 minutes of ingestion.[5] Lavage is also the initial treatment for [duodenal atresia](/source/Duodenal_atresia) in newborns, a condition where the small intestine is closed distal to the stomach, causing food and fluid to accumulate in the stomach. When the body temperature [rises above 40 °C](/source/Hyperthermia), gastric lavage with iced saline also can be an aggressive cooling measure in a [medical emergency](/source/Medical_emergency).

### Contraindications

Lavage is [contraindicated](/source/Contraindicated) when patients have a compromised, unprotected airway and in patients at risk of gastrointestinal [hemorrhage](/source/Hemorrhage) or perforation. Relative contraindications include when the poisoning is due to a corrosive substance (strong acids or strong bases) ([T54](https://icd.who.int/browse10/2019/en#/T54)), hydrocarbons ([T53](https://icd.who.int/browse10/2019/en#/T53)), or for poisons that have an effective [antidote](/source/Antidote).

## Complications

Many complications have been reported, although it appears serious complications are uncommon. The most dangerous risk is [aspiration pneumonia](/source/Aspiration_pneumonia), which is more likely to occur if hydrocarbons are ingested in patients without a protected airway. Other complications include [laryngospasm](/source/Laryngospasm), [hypoxia](/source/Hypoxia_(medical)), [bradycardia](/source/Bradycardia), [epistaxis](/source/Epistaxis), [hyponatremia](/source/Hyponatremia), [hypochloremia](/source/Hypochloremia), [water intoxication](/source/Water_intoxication), or mechanical injury to the stomach.[*[citation needed](https://en.wikipedia.org/wiki/Wikipedia:Citation_needed)*]

## References

1. **[^](#cite_ref-1)** ["Latest British Extracts"](http://trove.nla.gov.au/newspaper/article/2183729). *Sydney Gazette and New South Wales Advertiser*. 17 February 1825.

1. **[^](#cite_ref-FleisherLudwig2002_2-0)** Gary R. Fleisher; Stephen Ludwig; Benjamin K. Silverman (2002). [*Synopsis of pediatric emergency medicine*](https://books.google.com/books?id=eakFLQfJVl0C&pg=PA409). Lippincott Williams & Wilkins. pp. 409–. [ISBN](/source/ISBN_(identifier)) [978-0-7817-3274-1](https://en.wikipedia.org/wiki/Special:BookSources/978-0-7817-3274-1). Retrieved 4 August 2010.

1. **[^](#cite_ref-3)** Laura W Kates; Erik D Schraga (12 December 2008). ["Cooling Techniques for Hyperthermia: Treatment & Medication"](http://emedicine.medscape.com/article/149546-treatment). *eMedicine*. Omaha, Nebraska, USA: Medscape. p. 2. Retrieved 3 Nov 2010.

1. **[^](#cite_ref-jtoxclintox2004-vale_4-0)** Vale, JA; Kulig, K; [American Academy of Clinical Toxicology](/source/American_Academy_of_Clinical_Toxicology); European Association of Poisons Centres and Clinical Toxicologists (2004). "Position paper: gastric lavage". *J Toxicol Clin Toxicol*. **42** (7): 933–943. [doi](/source/Doi_(identifier)):[10.1081/CLT-200045006](https://doi.org/10.1081%2FCLT-200045006). [PMID](/source/PMID_(identifier)) [15641639](https://pubmed.ncbi.nlm.nih.gov/15641639). [S2CID](/source/S2CID_(identifier)) [29957973](https://api.semanticscholar.org/CorpusID:29957973).

1. **[^](#cite_ref-5)** ["BestBets: Method of gut decontamination"](http://www.bestbets.org/bets/bet.php?id=975).

## External links

- [NIH/Medline](https://www.medlineplus.gov/ency/article/003882.htm)

v t e Toxicology Fields Aquatic toxicology Ecotoxicology Occupational toxicology Entomotoxicology Environmental toxicology Forensic toxicology Medical toxicology In vitro toxicology Toxicogenomics Concepts Acceptable daily intake Acute toxicity Bioaccumulation Biomagnification Fixed-dose procedure Lethal dose Poison Toxic capacity Toxicity class Toxin Venom Treatments Activated carbon Antidote Cathartic Chelation therapy Gastric lavage Hemodialysis Hemoperfusion Whole bowel irrigation Incidents 1858 Bradford sweets poisoning 2007 pet food recalls Bhopal disaster Minamata disease Niigata Minamata disease Poisoning of Alexander Litvinenko Seveso disaster Consumption of Tide Pods Visakhapatnam gas leak 2022 Aqaba toxic gas leak List of poisonings Related topics Biological warfare Carcinogen Food safety Hazard symbol List of extremely hazardous substances Mutagen Occupational safety and health Category Commons WikiProject

v t e Tests and procedures involving the human digestive system Digestive system surgery Digestive tract Upper GI tract SGs / Esophagus Esophagectomy Heller myotomy Sialography Impedance–pH monitoring Esophageal pH monitoring Esophageal motility study Functional Lumen Imaging Probe High resolution manometry Stomach Sengstaken–Blakemore tube) Nasogastric tube Gastric lavage Bariatric surgery Adjustable gastric band Endoscopic sleeve gastroplasty Gastric bypass surgery Sleeve gastrectomy Vertical banded gastroplasty surgery Collis gastroplasty Gastrectomy Billroth I Billroth II Roux-en-Y Gastroenterostomy Gastropexy Gastrostomy Percutaneous endoscopic gastrostomy Esophagogastric dissociation Hill repair Nissen fundoplication Pyloromyotomy Schilling test Medical imaging Endoscopy Esophagogastroduodenoscopy Transnasal esophagoscopy Barium swallow Upper gastrointestinal series Lower GI tract Small bowel Bariatric surgery Duodenal switch Jejunoileal bypass Bowel resection Ileostomy Intestine transplantation Jejunostomy Partial ileal bypass surgery Strictureplasty Large bowel Appendectomy Colectomy Colonic polypectomy Colostomy Hartmann's operation Rectum Abdominoperineal resection Lower anterior resection Total mesorectal excision Ventral rectopexy Anal canal Anal sphincterotomy Anorectal manometry Lateral internal sphincterotomy Rubber band ligation Transanal hemorrhoidal dearterialization Medical imaging Endoscopy: Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy Stool tests Fecal fat test Fecal pH test Stool guaiac test Accessory Liver Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Hepatectomy Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt (TIPS) Distal splenorenal shunt procedure Gallbladder, bile duct Cholecystectomy Cholecystostomy Endoscopic retrograde cholangiopancreatography (ERCP) Hepatoportoenterostomy Medical imaging: Cholangiography Intravenous cholangiography (IVC) Magnetic resonance cholangiopancreatography (MRCP) Percutaneous transhepatic cholangiography (PTC) Cholecystography Cholescintigraphy Pancreas Frey's procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure Abdominopelvic Peritoneum Diagnostic peritoneal lavage Intraperitoneal injection Laparoscopy Omentopexy Paracentesis Peritoneal dialysis Hernia Hernia repair Inguinal hernia surgery Femoral hernia repair Other Laparotomy Exploratory laparotomy Rapid urease test / Urea breath test Clinical prediction rules Model for End-Stage Liver Disease (MELD) Pediatric end-stage liver disease (PELD) United Kingdom Model for End-Stage Liver Disease (UKELD) Child–Pugh score Ranson criteria Milan criteria

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Adapted from the Wikipedia article [Gastric lavage](https://en.wikipedia.org/wiki/Gastric_lavage) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Gastric_lavage?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.