Stomach Pumping

What is stomach pumping?

Stomach pumping is a medical procedure to suction out the contents of your stomach. It’s also called gastric suctioning or gastric lavage, which means washing. Both things happen during the procedure. A healthcare professional will alternately rinse your stomach with water or saline and then draw the contents out. They do this through a tube passed from either your nose or your mouth, into your stomach.

Why would you need your stomach pumped?

Most people know stomach pumping as an emergency procedure. If you swallow poison or overdose on pills, stomach pumping can help save your life by drawing out the toxins before your stomach absorbs them. But stomach pumping is also helpful in less dire circumstances. It can help relieve pressure in your stomach when it’s backed up with food, fluids or air. It can also clean out excess bleeding from a hemorrhage.

Gastric suctioning also plays a role in other common medical procedures. For example, if you’re having abdominal surgery, you’ll have gastric lavage and suctioning throughout the procedure to collect excess fluids. This helps prevent you from regurgitating and inhaling or choking on the fluids. Meanwhile, the saline wash helps sterilize your stomach to prevent infections.

What conditions or procedures involve gastric suctioning?

Medical conditions that might require stomach pumping include:

• Toxic ingestion (poisoning).
• Gastroparesis or gastric outlet obstruction.
• Small bowel obstruction or pseudo-obstruction.
• Intractable nausea and vomiting.
• Upper GI (gastrointestinal) bleeding.

Medical procedures that might involve gastric suctioning include:

• Gastrointestinal surgery.
• Assisted ventilation.
• Stomach acid test.
• Upper endoscopy.

How common is stomach pumping as an emergency procedure?

It’s not as common as it used to be. In recent decades, the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists have discouraged the routine use of stomach pumping for gastrointestinal decontamination. Their consensus is that other treatments, such as activated charcoal or whole bowel irrigation, may be safer and/or more effective in many cases.

What happens when you have your stomach pumped?

There are three parts to the procedure:

• Preparation.
• Intubation.
• Gastric suctioning/lavage.

What happens before stomach pumping?

You may need other treatments first before stomach pumping can safely proceed. Healthcare providers will monitor your vital signs before, during and after the procedure. If you’re lucid, they’ll discuss the procedure with you in advance and ask for your informed consent to proceed. They’ll test your gag reflex and install a breathing tube if necessary to help keep your airways open during the procedure.

How do they connect your stomach to the pump?

Stomach pumping happens through a tube that connects your stomach with a manual or mechanical pump on the other side. It’s either a nasogastric tube, which goes through your nose, or an orogastric tube, which goes through your mouth. Both types pass down through your esophagus (swallowing tube) into your stomach. For stomach emptying, you’re more likely to have an orogastric tube, which is wider.

To install the tube, your healthcare provider will:

1. Position you semi-upright or on your left side with your head angled down.
2. Apply a topical anesthetic spray to your throat. This helps prevent gagging.
3. Place a bite block in your mouth to prevent biting down on the tube (if it’s an orogastric tube).
4. Measure the correct length of tube they’ll need to reach your stomach and mark it.
5. Lubricate the tip of the tube to be inserted.
6. Aim the tube toward the back of your throat and into your esophagus.
7. Ask you to swallow or sip water through a straw if you’re able.
8. Slowly advance the tube until it reaches the mark, and then secure it.

If you cough, gag or show distress, your healthcare provider will immediately stop advancing and withdraw the tube. They’ll try again after a short break. Once the tube has reached its mark, they’ll use one of several methods to confirm that it’s in the right place. They might take an X-ray, or they might suction out a small sample of your stomach juices and test the pH to confirm it contains stomach acid.

How do they pump your stomach?

Once they’ve confirmed the placement of the tube, it’s safe to begin gastric lavage. Providers use different fluid solutions for lavage in different cases. It may be as simple as tap water or a saline solution. Saline helps prevent electrolyte losses from stomach pumping, especially in children and people already dehydrated from vomiting. Sometimes, the solution includes a specific poison antidote.

Your provider will:

1. Instill a small amount of fluid to irrigate your stomach (10 mL for a child or up to 300 mL for an adult). They may use a funnel to deliver it by gravity, or use a syringe or mechanical irrigant.
2. After one to two minutes, withdraw the fluid. Some pumps drain by gravity into a basin, and some use a syringe, suction bulb or mechanical suction.
3. Repeat the process until the fluid that comes back is clean or until two to three liters of solution has been used to irrigate your stomach. Irrigation helps to collect your stomach contents and to keep the tube open and prevent blockages.
4. If indicated, deliver activated charcoal through the last batch of irrigation fluid. Leftover poisons bind to the surface of the charcoal. Your provider may leave some of the charcoal solution in your stomach to pass through your intestines and collect any stray poisons there.

What does stomach pumping feel like (does it hurt)?

The pumping itself doesn’t hurt, but the tube may be uncomfortable, especially when it’s being inserted and withdrawn. Healthcare providers try to minimize this by lubricating the end of the tube and using topical anesthetics and a gentle technique. Still, you may continue to feel irritation or feel like gagging. Securing the tube in place helps to reduce friction, but friction can still occur when you move around.

What happens after the procedure?

Unless you’re having surgery, your provider will safely remove the tube, making sure to prevent any contact with the substances inside. (If you’re having surgery, the tube will stay in for a few days.) Healthcare providers will observe your recovery for the next few hours and watch for any signs of complications. If you’re being treated for toxic ingestion, they’ll watch for complications from that, too.

What are the advantages of stomach pumping?

In certain cases of toxic ingestion, stomach pumping can be lifesaving. Other times, it’s a helpful therapy that can relieve symptoms and allow further treatment or testing to proceed. And sometimes, it’s a precaution used to prevent you from having to empty your own stomach through vomiting. This is especially important during certain medical procedures, when vomiting would be more dangerous.

What are the possible risks or complications of stomach pumping?

With good technique, complications from the procedure should be minimal. But mistakes are always possible. Some possible risks and complications include:

• Injury from the tube to your stomach or esophagus.
• Aspiration (inhaling) of your stomach contents if you vomit from the procedure.
• Misplacement of the tube into your airway instead of your stomach.
• Cardiac arrhythmias (irregular heartbeats) if the tube triggers your vagus nerve.

When is stomach pumping indicated for toxic ingestion?

Stomach pumping is more effective when it happens soon after toxic ingestion. The longer the delay, the more poison will have already been absorbed. However, some toxins take longer to absorb than others, and a life-threatening dose may be reduced enough by stomach pumping to make a difference, even with some delay. So, healthcare providers elect stomach pumping based on the specifics of the case.

It may be indicated if:

• The toxic ingestion was recent (or the toxin is known to delay gastric emptying).
• The toxic ingestion was severe or life-threatening.
• The healthcare providers on site have expertise in the procedure.
• Other treatments are inadequate or unavailable.

It may not work or may be too dangerous if the person:

• Swallowed something caustic or corrosive.
• Swallowed a hydrocarbon that’s easy to aspirate (breathe in) like gasoline.
• Is actively fighting intubation.
• Is actively vomiting.
• Is having seizures.
• Is drowsy or unconscious and their airways aren’t protected.
• Ingested poison several hours ago.
• Is an infant.

How do you know when to get your stomach pumped?

Seek emergency care immediately if you know or suspect you or someone in your care has overdosed on drugs, has ingested poison or has alcohol poisoning. Signs of poisonous ingestion include:

• Dizziness.
• Nausea and vomiting.
• Heart palpitations.
• Breathing difficulties.
• Burns in or around the mouth.
• Chemical smell on the breath.
• Seizures.
• Restlessness or agitation.
• Altered mental status.
• Drowsiness or loss of consciousness.

If you don’t see obvious symptoms but still suspect poisoning, call for advice. Don’t try to treat toxic ingestion at home unless you receive specific guidance.

Stomach pumping may or may not be the recommended treatment for toxic ingestion, depending on many factors, such as what was ingested, how much and how long ago. In some cases, stomach pumping may be ineffective or too risky when compared with other treatments. Regardless of the specific treatment, poisoning should be treated as soon as possible and under medical supervision.

Other treatments for toxic ingestion may include:

• Activated charcoal.
• Specific poison antidotes.
• Whole bowel irrigation.
• IV fluids.
• Assisted ventilation.
• Seizure medications.
• Psychiatric evaluation and treatment.
• Addiction and recovery treatments.

A note from Cleveland Clinic

Stomach pumping as an emergency procedure is a common trope in film and television dramas. But in reality, it’s not the default treatment for an alcohol or drug overdose. Stomach pumping is only considered safe and effective for decontamination under certain conditions. Nevertheless, you or a loved one may need it for that purpose someday. It might be uncomfortable, but if you need it, it’s worth it.