Related Experiment Video
Updated: May 22, 2026
Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
Published on: April 26, 2019
A retrospective review of whole bowel irrigation in pediatric patients
Jean C Y Lo1, Cathy Ubaldo, F Lee Cantrell
1University of California-San Diego, Toxicology, San Diego, CA 92103, USA. jeanloem@hotmail.com
Insights
Whole bowel irrigation (WBI) in pediatric poisoning cases is effective for sustained-release medications. While transient adverse effects like vomiting occurred, WBI demonstrated utility in managing pediatric ingestions.
Area of Science:
- Toxicology
- Pediatric Emergency Medicine
- Gastroenterology
Background:
- Whole bowel irrigation (WBI) is traditionally used for ingestions of substances poorly adsorbed by activated charcoal, including extended-release and enteric-coated medications.
- Limited literature exists on WBI's use in pediatric poisoning cases, necessitating further investigation.
Purpose of the Study:
- To investigate the utilization and outcomes of whole bowel irrigation (WBI) in pediatric poisoning patients.
Main Methods:
- A retrospective chart review was conducted using the California Poison Control System electronic database.
- Data from human poisoning cases between 2000 and 2010 were analyzed.
Main Results:
- 176 pediatric cases receiving WBI were identified; the most common age was 2 years.
- Calcium channel blockers, iron, and antidepressants were the most frequent substances involved.
- Seventy-two cases involved sustained-release/delayed-release substances, with nifedipine, bupropion, verapamil, diltiazem, and felodipine being most common.
- Adverse drug reactions (vomiting, abdominal pain) occurred in 17 patients; 12 had pills in effluent.
Conclusions:
- Whole bowel irrigation (WBI) in pediatric poisoning is associated with transient adverse effects such as vomiting and abdominal pain.
- Polyethylene glycol plus electrolyte lavage solution (PEG-ELS) was more commonly administered via nasogastric tube, with higher doses in these patients.
Background:
Traditionally whole bowel irrigation (WBI) has been advocated for ingestions involving substances not bound with activated charcoal as well as extended release and enteric coated medications. Other than isolated case reports, little exists in the literature regarding the use of WBI in poisoned pediatric patients. The purpose of this study is to better understand the use of WBI in pediatric patients.
Method:
A retrospective chart review of California Poison Control System electronic database for human poisoning cases between the years 2000 and 2010 was performed.
Results:
A total of 176 cases were identified. The most common age of poisoned patients that received WBI was 2 years. There were more pediatric patients who received WBI between 2000 and 2005 then between 2006 and 2010. The top three substances in which WBI was used were calcium channel blockers, iron, and antidepressants. There were 72 cases involving sustained release and delayed release substances. The top five sustained release/delayed release substances were nifedipine, bupropion, verapamil, diltiazem, and felodipine. Adverse drug reactions were noted in 17 patients, vomiting in 16 patients and abdominal pain in one patient. In 36 cases, abdominal radiographs were performed. Sixteen were positive, and in four cases, repeat abdominal radiographs demonstrated a decrease in opacities. Twelve patients had documented pills in their effluent.
Conclusion:
Transient adverse drug reactions, vomiting and abdominal pain, were associated with WBI. Polyethylene glycol plus electrolyte lavage solution (PEG-ELS) was more frequently administered through the nasogastric tube. Patients who underwent WBI through nasogastric tube received higher doses of PEG-ELS.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:25Endoscopic Procedures II: Colonoscopy
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are: