There are few contraindications to performing whole bowel irrigation (Table 61-2). It should not be used in the setting of a patient with a potentially compromised or unprotected airway. Whole bowel irrigation could result in pulmonary aspiration.11,12 Significant vomiting will hinder the ability to perform whole bowel irrigation. It should not be performed in the hypotensive or hemodynamically unstable patient.11 Other contraindications include abnormal upper airway or upper gastrointestinal anatomy (e.g., anomalies, strictures, or fresh interposition graft). Ingestion of toxic substances that markedly slow gastrointestinal motility (e.g., anticholinergics or opioids) may cause an ileus, diminishing the ability to perform whole bowel irrigation effectively. The administration of polyethylene glycol in a patient with a bowel obstruction will result in vomiting with the potential for aspiration. This solution should not be used in patients with an actual or suspected perforated bowel. The risk of whole bowel irrigation is quite small but the procedure is not without effort, expense, and risk of complications. In this light, the risk–benefit ratio would be high if whole bowel irrigation were used to treat a nontoxic ingestion.