The phrase “pumping someone’s stomach” is a common, non-medical term describing an emergency procedure performed after a person has ingested a potentially toxic substance. This intervention is a form of stomach decontamination, often associated with cases of overdose or accidental poisoning. The procedure aims to remove unabsorbed material from the gastrointestinal tract before it causes systemic harm. While the term suggests simple suction, the medical reality involves a complex process of irrigation and removal used in hospital emergency departments to mitigate the effects of ingested toxins.
The Procedure’s Medical Name and Purpose
The correct medical term for “pumping the stomach” is Gastric Lavage, which translates literally to “stomach wash.” This name is more accurate because the procedure involves washing or rinsing the stomach contents rather than simple suction. The objective is to remove toxic materials, such as medications or poisons, before they move from the stomach into the small intestine where absorption into the bloodstream occurs. Removing the substance quickly significantly reduces the total amount of toxin that enters the body.
Gastric lavage is a form of gastrointestinal decontamination whose effectiveness depends heavily on timing. It is generally only considered if the ingestion of a potentially life-threatening dose occurred very recently, typically within 60 minutes. The procedure is not a routine intervention for all poisoning cases but is reserved for specific clinical situations where the ingested substance is profoundly toxic and the potential benefits outweigh the risks.
How the Procedure Works
The process of gastric lavage begins with the insertion of a large-bore tube, known as an orogastric tube, which is passed through the mouth and down into the stomach. The tube must be large enough to allow fragments of pills or other solid materials to pass through during the washing process. Before any fluid is introduced, the tube’s correct placement in the stomach must be confirmed, often by aspirating some stomach contents or using a chest X-ray.
Once the tube is properly positioned, the patient is typically placed on their left side with the head lowered slightly. This positioning helps prevent material from passing further into the small intestine and reduces the risk of aspirating stomach contents into the lungs. Small amounts of fluid, usually warm water or saline solution, are then introduced into the stomach through the tube. For adults, this aliquot is typically between 200 and 300 milliliters per cycle.
The introduced fluid is then removed, either by gravity drainage or gentle suction, effectively washing out the stomach and any unabsorbed toxins. This cycle of instilling and removing fluid is repeated multiple times until the fluid returning from the stomach is clear. This clarity indicates that most of the stomach contents have been removed, though the entire irrigation process may involve using several liters of fluid to ensure thorough decontamination.
Risks, Effectiveness, and Modern Alternatives
Despite its common portrayal in media, gastric lavage is rarely a first-line treatment in modern toxicology due to significant risks and limited effectiveness. One of the most serious complications is pulmonary aspiration, which occurs when stomach contents are accidentally inhaled into the lungs, potentially causing severe pneumonia. Other risks include mechanical injury to the esophagus or stomach lining from the large tube, and fluid or electrolyte imbalances, particularly if large volumes of fluid are used during the irrigation process.
Studies have shown that the procedure often removes an unreliable and sometimes negligible amount of toxin, especially if performed more than an hour after ingestion. In many cases, the procedure can even push some of the unabsorbed material past the stomach and into the small intestine, potentially increasing the rate of absorption. This combination of significant risk and uncertain benefit has led major toxicology organizations to strongly discourage its routine use.
The current standard of care for most poisonings involves the administration of Activated Charcoal, which is often safer and more effective. Activated charcoal is a fine, black powder that is highly adsorbent, meaning it can bind to many types of toxins in the gastrointestinal tract. This binding prevents the poison from being absorbed into the bloodstream, and the charcoal-toxin complex is then safely passed out of the body in the stool. Activated charcoal is easy to administer and does not carry the same mechanical risks as tube insertion.
Gastric lavage is now typically reserved only for ingestions of massive, life-threatening doses of substances that are not effectively bound by charcoal. Examples include iron, lithium, or certain alcohols, and only when performed very soon after the ingestion.