Feb 5, 2001: What is Whole Bowel Irrigation (WBI) and what are the indications for this procedure?

WBI cleanses the bowel by the enteral administration of polyethylene glycol electrolyte solution (PEG-ES) which induces a liquid stool.  WBI has the potential to reduce drug absorption by decontaminating the entire GI tract by physically expelling intraluminal contents.  PEG causes no net absorption or secretion of ions, so no significant changes in water or electrolyte balance occur.  WBI is best administered through a NG tube.  There are no dose-response studies but recommended dosing is:

Children 9 mos-6years    500mL/h

Children 6-12 years           1000mL/h

Adolescents and adults   1500-2000mL/h

WBI is an option for potentially toxic ingestions of sustained-release (SR) or enteric-coated drugs, iron or other ions such as lithium, or packets of illicit drugs.  WBI is used most frequently in children who have ingested SR calcium channel blockers.  Nausea, vomiting and abdominal cramps are the potential complications.