Why is gastric lavage not recommended for zinc phosphide poisoning?

In cases of zinc phosphide poisoning, gastric lavage is not recommended due to its corrosive nature, which could exacerbate esophageal and gastric damage. Instead, immediate administration of activated charcoal is advised to help absorb the toxin and reduce its conversion to phosphine gas in the stomach. This should be done cautiously with careful consideration of the patient's airway protection. If the patient is seen very early after ingestion and there are no contraindications, a small amount of water or milk may be given to help dilute the substance, but this must be done with extreme caution and is not a substitute for activated charcoal. The primary focus should be on supportive care, including monitoring for and managing potential complications such as respiratory distress, cardiac issues, and renal failure. Given the high risk of morbidity and mortality associated with zinc phosphide poisoning, prompt medical attention and intensive care unit admission may be necessary for close monitoring and aggressive management of any complications that arise.