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Gastric lavage | Diseases and conditions: Medical tests.

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What is Gastric lavage

Gastric washing is a technique that allows you to empty the contents of the stomach to avoid passing the rest of the digestive tract and is absorbed. For this purpose, a probe is inserted through the nose or mouth, and extends through the esophagus to the stomach. With this probe, the stomach contents can be absorbed (why to gastric lavage also is called 'gastric suction'), and you can get water that clean the inside of the stomach. It is a technique that carry out daily doctors or nurses in hospital admissions and emergency services. Although it is easy to make and very useful, no longer an invasive technique that should be limited to situations where it is necessary.
Throughout history man has always linked what we eat with illnesses or poisoning. Very soon saw the need to empty the stomach of toxic products or in poor condition. In the ancient Greece the emptying of the stomach was performed with substances that produce vomiting, as syrup of ipepacuana, which is still used today. In 19th century medicine began to develop gastric lavage through probing techniques, but the probes were so thick and uncomfortable that really its effectiveness rested on it caused vomiting the patient, rather than sucking stomach contents.
Techniques such as gastric lavage have allowed to save the life of many people before severe intoxications voluntary or involuntary. Its ease of implementation and its cost, have allowed to be a technique very effectively and widely used in hospitals around the world. The associated risks are rare, the most negative aspect of the technique is the discomfort for the person that is performed.

When is a gastric lavage

He is gastric lavage in the following situations:
Remove stomach accidentally ingested poisons or toxic substances.
Extract overdose of drugs, that may have been swallowed accidentally or willingly.
Check the presence of fresh blood into the stomach, to be ruled an active bleeding if not present.
Clean the inside of the stomach of blood or food before performing a gastroscopy.
Decompress the stomach inside when there is a bowel obstruction; with the probe air exits through the mouth and the stomach does not swell.
Take samples of gastric juices, to analyze their chemical composition or search for microorganisms.

Preparation for gastric lavage

If you are performing a gastric washing these are the issues that you must take into account:
Duration: gastric lavage has a variable duration according to the motives that lead to do so. You can take from a few minutes (if you want to extract toxic that they have ingested) up to several hours (to decompress the digestive tract before bowel obstruction).
Income: gastric lavage does not require an income. However, it is a test that should be done in a medical facility or in a hospital. Exceptionally, there are emergency utilities that can perform initial gastric lavage before moving the patient to the hospital. Once gastric lavage, you can return to your place of residence or stay entered, but the reasons shall be independent of having carried out the test.
Is necessary to be accompanied?: Yes, it is recommended, but not essential. Test is annoying but you not disabled, the problem is that if they have made you the test probably your medical situation may be a little sensitive, and so it is better that someone is on your side.
Drugs: don't need to take any prior medication. You should tell your doctor all the medicines taken regularly and will decide which suspend or maintain. One of the reasons for conducting gastric lavage is taking excessive drugs, voluntarily or not, so it is important to tell your doctor what you have taken, when and how many.
Food: is indifferent to the test. In fact, it can be used to clean the stomach of foods that are eaten in the last hours.
Clothing: once one gets to the emergency room in street clothes is changed to a more comfortable and suitable to carry out tests and explore you gown. Clothing is recommended for sleep and comfortable shoes if you're going to join later.
Documents: it is recommended to carry the health insurance card and complete medical history. Before you undergo the intervention they will ask you if you're in agreement and if you give your oral consent, which you agree to make yourself the technique. If you are unconscious consent will give your next-of-kin or guardian.
Pregnancy and breast-feeding: gastric lavage should be limited to the second trimester of pregnancy when necessary, though in very urgent situations it may be done at any time. There is nothing that contraindicated during lactation gastric lavage.
Contraindications: the only absolute contraindication is to have any blockage that prevents the passage of the probe. Are relative contraindications uncontrollable vomiting of repetition, or do not support the probe for a few minutes; in both cases you can advertise medications that relax the patient and stop nausea.

How gastric lavage

Make you a washed stomach first make you a detailed interview about food and drugs ingested in the last hours. We will also ask you for other symptoms that can motivate the realization of the technique. In the event that you arrive unconscious, questions will be directed to your family members or companions. If you're not unconscious will regard you a sedative medication; so you'll be relaxed and discomfort of the probe nasogastric tube will be lower.
Once sedated, the doctor or nurse will introduce slowly a tube through the nose or mouth. That probe will pass through the pharynx, the esophagus will reach, and will pass through it until you reach the stomach. It is important that the probe will pass to esophageal arriving to the pharynx, and not to the trachea because, if not, would the lungs. To check that it has been placed properly be introduced a little air, which must inflate the stomach and not the lungs.
When you reach your stomach the contents is sucked and will be collected in a bag or in a transparent container that exist in the outer end of the probe. Thus the stomach contents can be seen directly and check for the presence of blood, drugs, or food particles. You will only draw a few cubic centimetres of volume. If necessary it will suck more, but if you decide to clean the entire contents of the stomach saline must be introduced first.
The saline solution is passed through the tube with a syringe. Thus the stomach fills with water and diluted its content. Then she sucks and collected content. This step can be performed several times to rinse all the stomach cavity and let it clean of toxic. Sometimes the doctor will consider necessary to introduce substances that act as neutralizing the toxins ingested through the probe. The substance most used in these cases is activated carbon, which is capable of removing most of the medicines and toxic that they ingest.
When washing is completed, you can leave you probe long enough until it is checked that it is not necessary to repeat new washes or your medical situation is stable enough to stay without probe. The technique does not require you to stay longer in the emergency room, but it is likely that they prefer to be in observation at least for a few hours, to check that your body has not absorbed toxic, depending on the context.

Complications of gastric lavage

Gastric washing It is a safe and widely used technique today, but is not without risk, as with any other invasive technique. That currently use has been limited to cases in which it is necessary to do so.
The most common problems that can result are:
Minor bleeding , tear the wall of the digestive tract to the probe.
Passage of the probe to the trachea, sometimes causing pneumonia.
Spasm of the vocal cords reagent, which impedes breathing for a few seconds.
The wall of the esophagus or stomach, sometimes reaching a hole that requires surgery injury during technique .
Problems caused by sedation, as it can happen in other procedures.
Passage of gastric contents into the small intestine, to push it with the probe.

Results of gastric lavage

Gastric washing depends of if they have done it you awake or were unconscious. If you were unconscious, when you wake up you'll be drowsy, and you can have nausea. It is also normal that it hurts you throat when swallowing or you notice it a little bit asleep. Doctors will put any medication to prevent you vomites. If you were aware, you will better control the symptoms and you'll notice relief to take off the probe.
Gastric contents is not usually to analyze when the toxic substance ingested is known, as in voluntary or accidental drug overdoses. Laboratory will only take when you do not know what had caused the poisoning, or when it wants to study the composition of the gastric juices by some other disease. If they have been analyzed, the doctor can give you an appointment another day, which give you the results and explain the nature of the analyzed substances.
The most important results of gastric lavage is your general State after the intervention. If the technique is successful you won't metabolic alterations, which happen when they absorb toxic by digestive tract. The doctor, in addition, is usually performed analysis of blood before and after gastric lavage, leaving a margin hours. So make sure that all parameters are correct and will appreciate if let you leave home or enter you in the hospital for studies and subsequent tests.
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