Use of cathartics in toxic ingestions.

Cathartics are commonly recommended for treatment of ingestion of toxic substances. Literature review shows little evidence of efficacy of this practice. Published reports of morbidity are limited to pediatric patients experiencing electrolyte imbalance. Our survey of the members of the American Board of Toxicology, as well as our literature review, form the basis for suggesting catharsis of most patients when treating toxic ingestions. However, caution must be used in very old or very young patients, in those with preexisting renal disease or ingestion of nephrotoxic substances, in corrosive ingestions, in patients with recent bowel surgery or absent bowel sounds, and in patients with hypertension or congestive heart failure. Oil catharsis is not recommended.