Gastric Content Analysis in Clinical and Toxicological Investigations: Is It a Valuable Tool?

Abstract

Introduction

Poisoning is a major global health concern and remains a leading cause of preventable injury-related mortality worldwide. According to the World Health Organization, poisoning accounted for approximately 84,000 deaths globally in 2019. In Pakistan and other LMICs, poisoning continues to be a significant public health burden, with unintentional exposure contributing substantially to mortality. Self-poisoning is more prevalent in LMICs due to pesticide availability, socioeconomic stressors, and limited access to emergency toxicology services. In contrast, high-income countries report drug overdoses as the leading cause of poisoning-related deaths.^1,2

Initial management of suspected poisoning in emergency settings includes gastrointestinal decontamination strategies such as gastric lavage, activated charcoal administration, and supportive care.³ Gastric lavage is most effective when performed within one hour of ingestion; beyond this period, systemic absorption reduces its efficacy.⁴ Although the clinical use of gastric lavage has declined, gastric content analysis continues to provide valuable diagnostic and forensic information in selected cases. However, its role in modern toxicology remains under discussion due to methodological and economic limitations.