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Nasogastric Intubation and Feeding

What is nasogastric intubation?

Key points

  1. In nasogastric (NG) intubation, a tube is placed through your nose into your stomach.
  2. Your healthcare provider can use an NG tube to feed you and give you medicine.
  3. They can also apply suction to an NG tube to remove stomach contents.

If you can’t eat or swallow, you may need to have a nasogastric tube inserted. This process is known as nasogastric (NG) intubation. During NG intubation, your doctor or nurse will insert a thin plastic tube through your nostril, down your esophagus, and into your stomach. Once this tube is in place, they can use it to give you food and medicine. They can also use it to remove things from your stomach, such as toxic substances or a sample of your stomach contents.

When would you need nasogastric intubation?

purpose

NG intubation is most commonly used for patients who:

  • have neck or facial injuries
  • have had neck or facial surgery
  • need a mechanical ventilator to breathe
  • have an intestinal obstruction or blockage
  • are comatose

It’s also used to help treat some premature infants.

Your doctor or nurse can give you food and medicine through an NG tube. They can also apply suction to it, allowing them to remove contents from your stomach. For example, your doctor may use NG intubation to help treat accidental poisoning or drug overdose. If you’ve swallowed something harmful, they can use an NG tube to try to remove it from your stomach or deliver treatments. For instance, they may administer activated charcoal through your NG tube to help absorb the harmful substance. This can help lower your chances of a severe reaction.

Your doctor or nurse can also use an NG tube to:

  • remove a sample of your stomach contents for analysis
  • remove some of your stomach contents to the relieve the pressure on an intestinal obstruction or blockage
  • remove blood from your stomach

How should you prepare for nasogastric intubation?

Preparation

If you need to have an NG tube inserted, it will probably happen in a hospital. In some cases, you may get the tube inserted at home. In most cases, you won’t need to take any special steps to prepare. Right before it’s inserted, you may need to blow your nose and take a few sips of water.

What will the procedure involve?

process

Your doctor, nurse, or other care provider will insert your NG tube while you’re lying down in a bed with the head elevated or sitting in a chair. They will likely ask you to bend your head, neck, and body at various angles as they thread the tube through your nostril, down your esophagus, and into your stomach. These movements can help ease the tube into position, without causing you too much pain or discomfort. They may also ask you to swallow or take small sips of water when the tube reaches your esophagus to help it slide into your stomach.

Once your NG tube is in place, your care provider should take steps to check its placement. For example, they might try to draw fluid out of your stomach. Or they might insert air through the tube, while listening to your stomach with a stethoscope.

To keep your NG tube in place, your care provider will likely secure it to your face with a piece of tape. They can reposition it if it feels uncomfortable.

What are the benefits of nasogastric intubation?

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If you can’t eat or drink, NG intubation and feeding can help you get the nutrition and medications you need. NG intubation can also help your doctor treat an intestinal obstruction in ways that are less invasive than intestinal surgery. They can also use it to collect a sample of your stomach contents for analysis, which can help them diagnose certain conditions.

What are the risks of nasogastric intubation?

Risk Factors

If you’re conscious when your NG tube is inserted, you may feel some discomfort as the tube passes through your nostril into your stomach. If your NG tube isn’t inserted properly, it can potentially injure the tissue inside your nose, sinuses, throat, esophagus, or stomach. Your care provider may also mistakenly thread it through your windpipe into your lungs. If this happens, they may accidentally pass food or medicine into your lungs. This is known as aspiration. It can lead to pneumonia or other infections.

NG tube feeding can also potentially cause:

  • abdominal cramping
  • abdominal swelling
  • diarrhea
  • nausea
  • vomiting
  • regurgitation of food or medicine

Your NG tube can potentially become blocked, torn, or dislodged. This can lead to additional complications. Using an NG tube for too long can also cause ulcers or infections to develop on the tissue of your sinuses, throat, esophagus, or stomach. If you need long-term tube feedings, your doctor will likely recommend a gastrostomy tube. They can surgically implant a gastrostomy tube in your abdomen to allow your care providers to introduce food directly into your stomach.

How can you lower your risk of complications?

Next steps

To lower your risk of complications from NG intubation and feeding, you or your healthcare provider can:

  • brush your teeth regularly
  • clean your nose frequently
  • tape the tube securely to your face
  • check the tube for signs of leakage, blockage, and kinks
  • elevate your head during feedings and for an hour afterwards
  • watch out for signs of irritation, ulceration, and infection

Ask your doctor for more information about your specific treatment plan and outlook.

You asked, we answered

  • It feels uncomfortable; will this ease as I get used to it?
  • It probably will not ease as time passes, though you might find some ways to minimize the discomfort. If the tube is placed correctly, any discomfort is usually caused by the tube rubbing against tissue. Occasionally the nares will become irritated from the tube rubbing against them. If this happens, be sure the tube is secured with tape in a position that does not cause pressure on the nares. Similarly, the tube can rub and cause a sore throat. Sucking on ice chips may help. Also, a numbing spray such as Cetacaine or Chloraseptic lozenges may offer temporary relief.

    - Healthline Medical Team

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