UMEM Educational Pearls

Category: Toxicology

Title: Whole Bowel Irrigation Position Paper Update... Well, Not Really

Keywords: whole bowel irrigation, WBI, GI decontamination (PubMed Search)

Posted: 1/6/2015 by Bryan Hayes, PharmD (Emailed: 1/8/2015) (Updated: 1/15/2015)
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The original position paper on the use of whole bowel irrigation (WBI) was first published in 1997 by the American Academy of Clinical Toxicology (AACT) and the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) and updated in 2004.
The 2015 iteration concludes, "There is no new evidence that would require a major revision of the conclusions of the 2004 position statement."
Potential Indications
  1. Potentially toxic ingestions of sustained-release or enteric-coated drugs
  2. Substantial ingestions of iron, lithium, or potassium
  3. Removal of ingested packets of illicit drugs in "body packers"

Application to Clinical Practice

WBI can facilitate removal of select toxicants from the gastrointestinal tract in some patients, but there is no convincing evidence from clinical studies that it improves the outcome of poisoned patients.


Thanacoody R, et al. Position paper update: Whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clin Toxicol 2015;53(1):5-12. [PMID 25511637]

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