A nasogastric (NG) tube is a thin, soft tube made of plastic or rubber that is passed through the nose, down through the throat, and into the stomach. It is used to deliver food or medicine to the stomach for people who have difficulty eating or swallowing. It can also be used to remove liquids or air from the stomach.
The placement of an NG tube, called nasogastric intubation, can be uncomfortable but is usually not painful. When used to deliver liquid nutrition, the procedure is often referred to as "tube feeding."
This article describes the various reasons why you might need an NG tube, how the tube is inserted, and the possible risks and complications of this common medical procedure.
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Why Are NG Tubes Used?
When a person is unable to tolerate solid foods by mouth, an NG tube might be used to give nutrients via liquid nutrition. It can also be used to give medications in some situations.
The most common reasons for using an NG tube include:
- Administering nutrients and medication
- Removing liquids or air from the stomach
- Adding contrast to the stomach for X-rays (a dye that helps differentiate structures so they can be better viewed on scans)
- Protecting the bowel after surgery or during bowel rest
An NG tube can be used by adults or children. In children, NG tube feeding may be necessary because of swallowing difficulties, digestive issues, inflammation, or other medical conditions. This can prevent a child from getting proper nutrition from food, breast milk, or formula.
Click Play to Learn All About NG Tubes
This video has been medically reviewed by Anju Goel, MD, MPH.
An NG tube is sometimes automatically inserted after abdominal surgery of any kind. Before having surgery, your doctor should let you know if you may wake up with an NG tube.
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How Is an NG Tube Inserted?
An NG tube is placed by a doctor or a nurse. Usually, the procedure is done in the hospital. While there are instances when the doctor may need to put you to sleep to place the tube, most people are awake during the procedure.
First, your nasal area might be numbed with either lidocaine or an anesthetic spray. Often, the NG tube is coated with a lubricant gel to help it go down easier. The NG tube is then inserted up through the nostrils, down through the esophagus, and into the stomach.
Your doctor will usually tell you to swallow while the NG tube is being placed. The procedure is uncomfortable, but it shouldn't be painful. If you do feel pain, it could be a sign that the tube isn't placed properly.
Your doctor may check the tube by adding or removing some stomach contents. They may also order an X-ray to ensure that the tube is in the correct position.
Finally, the outside of the tube will be taped down onto the skin so that it doesn't become dislodged accidentally.
Risks and Complications
NG tube feeding can cause unpleasant side effects like reflux, nausea, and vomiting in some people. Other NG tube complications include:
- Abdominal cramps
- Aspiration
- Diarrhea
- Injury to the esophagus, throat, sinuses, or stomach
- Swelling
Diarrhea
A common complication associated with NG feeding tubes is diarrhea. The risk of diarrhea depends on whether you have other underlying conditions.
Using different medications while having a feeding tube also affects your risk, as does receiving tube feeds through the NG tube.
With diarrhea, you may experience an imbalance of electrolytes (minerals that help muscles contract and keep you hydrated), malnutrition, and infection, so it is important to receive proper treatment if it occurs.
Injury
During insertion, there is the risk of injury to the esophagus, throat, sinuses, or stomach.
While an NG tube is most commonly inserted without a problem, there are instances when it can lead to life-threatening injuries.
Those who have serious underlying medical conditions and are unable to properly swallow the tube are most at risk for severe compilations. Placing the tube into the stomach via the mouth (instead of through the nasal cavity) may help limit the risk in those cases.
Dislodgement
Even once it's properly placed, it's possible that an NG tube could get blocked or torn. It can also move out of place, which is known as dislodgement.
Dislodgment occurs in 25% to 82% of patients who receive an NG feeding tube. The risk of this is greater in older adults with cognitive problems, who may disrupt the tube because they don't understand what the tube is or why they have it.
Aspiration
In some situations, food or medicine being put through the tube can come back up. If these substances enter the lungs, it causes aspiration pneumonia.
This is a serious, life-threatening problem. Aspiration pneumonia is the most common cause of death among elderly people with an NG feeding tube.
Difficulty Speaking
An improperly positioned nasogastric tube can make it hard to talk. This can occur if it interferes with the functioning of the larynx (vocal cords) and cause a person to sound hoarse. Vocal hoarseness can also be due to irritation during tube placement, which resolves on its own in a day or two.
However, vocal hoarseness accompanied by difficult or labored breathing could be a sign of nasogastric tube syndrome (NGS). NGS is a rare but potentially life-threatening condition where vocal cord paralysis causes upper airway obstruction.
Contact your healthcare provider if you have a hoarse voice with an NG tube. In many cases, once the tube is repositioned, your voice should sound normal.
When to Seek Medical Care
Individuals with an NG tube should seek emergency medical treatment for the following:
- Difficulty breathing
- Evidence of blood in the tube, stomach contents, or stool
- Vomiting, choking or coughing during feeds
Less serious signs that warrant a call to your healthcare provider include:
- Bloating or abdominal distention
- Clogged in the tube that you cannot clear up
- Fever or other signs of infection
- Hoarse voice
- Redness, swelling, or irritation in both nostrils
- The tube becomes dislodged or falls out
- Vomiting between feeds
Dealing With an NG Tube
Most patients agree that an NG tube is a difficult thing to deal with and can be uncomfortable, especially when it's being placed. However, it can help prevent surgery in some cases and provide life-saving benefits.
The bottom line is that it's uncomfortable, but it shouldn't be painful, and it may help you avoid more invasive procedures that would cause greater discomfort. An NG tube is temporary, so it will be in place only for as long as it's needed, which, in many cases, may be only a few days.
Summary
An NG tube can be used as a temporary feeding tube. It may also provide medication to people unable to swallow. In some instances, an NG tube may also be used to remove substances from the stomach.
The NG tube can be a life-saving tool. However, it comes with some significant drawbacks, such as discomfort, potential injury, and additional medical problems.
There are times when an NG tube may be necessary, and other times it may be optional. Discuss your circ*mstance with your doctor.
