Gastrointestinal decontamination for acute poisoning.

Acute poisoning remains a common cause of morbidity and even mortality in children and adults. The goal of gastrointestinal decontamination is to eliminate or to reduce the potentially life-threatening effects of the ingested poison. Methods of gastrointestinal detoxication in case of acute poisoning, such as induced emesis, gastric lavage, administration of activated charcoal and intestinal cleansing are discussed. As far as induced emesis is still concerned, only the administration of Ipecac-syrup can be retained. The controversy between emesis and gastric lavage still remains. For those toxins well adsorbed by activated charcoal, the administration of activated charcoal, followed or not by gastric lavage, is the treatment of choice. Single doses of activated charcoal can be insufficient. In certain kinds of poisoning, repeated doses of activated charcoal are advisable because of the interruption of the entero-hepatic and entero-enteric circulation. The benefit and the indications for intestinal cleansing in case of acute poisoning seem to be very limited.