[Measures for the acceleration of toxin excretion via liver, bile and intestines]

It is possible to enhance elimination of already absorbed xenobiotics through the gastrointestinal tract by influencing distribution, by specifically inducing metabolism, by interrupting the enterohepatic circulation, and by increasing intestinal secretion, respectively. Case reports of clinical experiences, however, are not sufficient support for a rational and comprehensive concept of secondary decontamination (i.e. all measures to enhance elimination of substances that have been absorbed). This is especially true during and after either subacute or chronic exposure to harmful xenobiotics. Further scientific work in the laboratory is needed to provide the necessary background for controlled clinical studies. Highly lipophilic compounds with a long terminal half-life, as for example amiodarone or persistent environmental pollutants, will challenge such a concept.