Whole bowel irrigation is a method of gastric decontamination in the
poisoned patient involving administration of large volumes of
osmotically balanced polyethylene glycol-electrolyte solution to empty
the gastrointestinal tract of ingested toxins before absorption,
limiting systemic toxicity. While this approach may seem intuitive and
it can lead to expulsion of tablets or packets in the rectal effluent,
there is a lack of evidence correlating this with improved patient
outcomes. Administration of whole bowel irrigation is also challenging
to the inexperienced physician and associated with adverse effects,
which may be serious. Recommendations for the consideration of whole
bowel irrigation are limited to patients who have ingested modified
release preparations, those of have ingested pharmaceuticals not
adsorbed by activated charcoal, and for the removal of packages in body
packers. Until more robust evidence is available from high-quality
prospective studies demonstrating efficacy, the use of whole bowel
irrigation should not be used routinely in poisoned patients.