No good evidence supports gastric lavage in iron overdose
Report By: Stewart Teece - Research Fellow
Search checked by Ian Crawford - Research Fellow
Institution: Manchester Royal Infirmary
Date Submitted: 1st March 2000
Date Completed: 7th November 2002
Last Modified: 5th October 2004
Status: Green (complete)
Three Part Question
In [overdose with iron compounds] is [gastric lavage better than no treatment] at [reducing toxicity]?
A 29 year old woman presents to the emergency department 30 minutes after swallowing 40 ferrous sulphate tablets. Given the recent onset and the apparent low efficacy of activated charcoal in iron compounds you wonder whether she is a candidate for gastric lavage.
Medline 1966-01/02 using the Ovid interface
[exp irrigation OR lavage.mp OR exp gastric lavage OR gastric lavage.mp OR exp gastric emptying OR wash-out.mp] AND [(exp iron OR iron.mp OR exp iron compounds OR exp ferrous compounds OR ferrous.mp OR exp ferric compounds OR ferric.mp] AND [exp poisoning OR poisoning.mp OR exp overdose OR overdose.mp OR DSH.mp] LIMIT to human AND English.
54 papers were found, none of which were relevant to the three part question
For UK position statement on gastric lavage see http://www.spib.axl.co.uk/toxbaseindex.htm
Clinical Bottom Line
There is no currently available evidence to support the use of gastric lavage in the overdose of iron compounds. Local advice should be followed.
Level of Evidence
Level 3 - Small numbers of small studies or great heterogeneity or very different population.