EUROMEDICA  Hanover 6-7  Juni 2008	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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During acute poisoning a large part of toxic substances concentrates in the cavity of the gastrointestinal tract, especially when the peroral way of poisoning takes place. There is always the paresis of gastrointestinal tract (GI tract) that makes it considerably difficult to remove toxic substances from the cavity of the bowel. For quick and efficient removal of toxic substances a new method of purification of GI tract with intestinal lavage was developed in the department of treatment of acute poisoning in the N.V. Sklifosovsky Research Institute of First Aid in Moscow.

Intestinal lavage - is lavaging in the natural direction the whole GI tract with a special salt solution which is identical to the composition of chime in the electrolyte composition, osmolarity and pH. The aim of this lavaging is to remove toxic substances from the body, correct the parameters of homeostasis, functional disorders of organs and systems and microbiocoenosis of intestine.

As a result of lavaging the gastrointestinal tract its contents including toxic substances are removed, the natural drainage of the biliary system and pancreas is improved, the concentration of poisons of exogenous and endogenous origin in blood decreases. Initially high contents of bilirubin, urea, creatinine and other products of metabolism in blood are also reduced. Filterability of the kidneys is improved. This treatment method has advantages as compared with hemodialysis, hemosorption, plasmapheresis and enterosorption. Under our supervision there were 83 patients with acute peroral poisoning caused by psychotropic drugs of carbamazepine and 12 patients with acute alcohol intoxication, complicated by acute alcoholic hepatitis.

Hemosorbtion combined with other methods of treatment was the basic method of removing toxic substances from the body for all the patients with carbamazepine poisoning. 35 of these patients were treated with intestinal lavage.

During the use of the intestinal lavage in the complex removal of toxic substances from the body the consciousness and self-breathing restored to 1.6 times faster. The mortality in various stages of intoxication decreased in 1,7 – 2,3 times respectively. The period patients stay in hospital reduced in 1,4 times. In addition, the dynamics of advanced recovery performance of homeostasis was noted, the conductivity was improved and metabolic disorders in the myocardium were restored. 12 patients with alcoholic hepatitis in latent and icteric forms which were confirmed by laboratory studies had common protective liver therapy, and 8 patients had intestinal lavage in the indicated range. As a result of intestinal lavage the liver function recovered faster as compared with the control group, the duration of treatment in hospital decreased. Thus the use of intestinal lavage allows removing toxic substances from the GI tract in the shortest term, which increases the efficiency of detoxification of the body. The effect of detoxification is supplemented by the nonspecific effect of correction of some indices of homeostasis (normalization of body temperature, central haemodynamics, electrolytic and acid-base status of blood, hemoconcentration), stimulation of the motor-evacuative bowel function. The technical simplicity and low cost, compared to hemosobtion and plasmapheresis, makes intestinal lavage perspective for practical medicine in selecting the method of blood purification. Intestinal lavage is extremely effective against exotoxication and endotoxiation, including acute pancreatitis, hepatitis, nephritis, diseases of the skin lesion / atopic dermatitis, psoriasis, eczema / allergies, constipation with 1-3 degrees of functional nature, diarrhea, pancreatic diabetes of the 2^nd type, alcohol withdrawal syndrome, syndrome, alcohol hallucinosis, delirii, preparations for elective surgeries and colonoscopy.