Whole Bowel Irrigation (PEG-ES)
Whole Bowel Irrigation (WBI) is a decontamination process that involves the rapid administration of large quantities of an osmotically balanced polyethylene glycol-electrolyte solution (PEG-ES). The solution is formulated to pass through the bowel without being absorbed or causing electrolyte imbalances, mechanically flushing out ingested toxins before they can be absorbed into the body.
Dosage by Body Weight
Typically administered via a nasogastric tube (or taken orally if tolerated) at a rapid rate until the rectal effluent is clear. General age-based rates are: Adults (1.5 to 2 L/hr), Children 6-12 years (1 L/hr), and Children 1-6 years (500 mL/hr). Airway protection must be assessed before and during administration.
- Body Weight
- Below 5 kg
- Dose
- Not routinely recommended
- Frequency
- Continuous infusion
- Tracking Notes
- Administer only in a pediatric intensive care setting under direct medical supervision if deemed critically necessary.
- Body Weight
- 5-7 kg
- Dose
- 150 to 250 mL per hour
- Frequency
- Continuous infusion
- Tracking Notes
- Administer via nasogastric tube. Monitor closely for fluid overload, abdominal distension, and vomiting.
- Body Weight
- 8-10 kg
- Dose
- 250 to 300 mL per hour
- Frequency
- Continuous infusion
- Tracking Notes
- Administer via nasogastric tube. Discontinue immediately if vomiting, aspiration, or signs of bowel obstruction occur.
- Body Weight
- 11-15 kg
- Dose
- 300 to 400 mL per hour
- Frequency
- Continuous infusion
- Tracking Notes
- Administer via nasogastric tube. Continue treatment until the rectal effluent is clear and free of drug residue.
- Body Weight
- 16-20 kg
- Dose
- 400 to 500 mL per hour
- Frequency
- Continuous infusion
- Tracking Notes
- Administer via nasogastric tube or orally if tolerated. Continue treatment until the rectal effluent runs clear.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Not routinely recommended | Continuous infusion | Administer only in a pediatric intensive care setting under direct medical supervision if deemed critically necessary. |
| 5-7 kg | 150 to 250 mL per hour | Continuous infusion | Administer via nasogastric tube. Monitor closely for fluid overload, abdominal distension, and vomiting. |
| 8-10 kg | 250 to 300 mL per hour | Continuous infusion | Administer via nasogastric tube. Discontinue immediately if vomiting, aspiration, or signs of bowel obstruction occur. |
| 11-15 kg | 300 to 400 mL per hour | Continuous infusion | Administer via nasogastric tube. Continue treatment until the rectal effluent is clear and free of drug residue. |
| 16-20 kg | 400 to 500 mL per hour | Continuous infusion | Administer via nasogastric tube or orally if tolerated. Continue treatment until the rectal effluent runs clear. |
Formulation
Purpose
Used for gastrointestinal decontamination in patients who have ingested toxic quantities of sustained-release medications, enteric-coated drugs, heavy metals (such as iron, lead, or lithium), or packets of illicit drugs.
Generic Name
Polyethylene Glycol-Electrolyte Solution (PEG-ES)Branded Drug Names
Whole Bowel Irrigation (PEG-ES) is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
No. This medicine is generally not treated as a scheduled/prescription-only drug in common consumer references, but local rules may vary.