Nasogastric (NG) Tubes and IBD

A nasogastric (NG) tube is a flexible tube of rubber or plastic that is passed through the nose, down through the esophagus, and into the stomach. It can be used either to remove substances from or add them to the stomach. An NG tube is meant to be used only on a temporary basis and is not for long-term use.

Illustration showing the nasal cavity

Leonello Calvetti / Science Photo Library / Getty Images

NG tubes after surgery for inflammatory bowel disease (IBD) used to be common and were placed as a matter of course. It's now thought that an NG tube is not always needed for every type of surgery or for every patient.

Before having surgery, discuss the NG tube with a surgeon to find out if one will be placed after surgery, or if there are any circumstances or complications that can arise that will mean an NG tube is needed. 

Why Are NG Tubes Used?

People with IBD sometimes have NG tubes placed at other times, especially while in the hospital. An NG tube might be put in place for several reasons, including:

  • Administering nutrients or medication
  • Removing liquids or air from the stomach
  • Adding contrast to the stomach for X-rays
  • Protecting the bowel after surgery or during bowel rest

Not everyone who has surgery for IBD also has an NG tube: It depends on the reason for the surgery and the decision of the surgical team. Sometimes an NG tube is a way to treat an intestinal blockage associated with IBD, without having to do surgery.

In some cases, when a person is unable to tolerate solid foods by mouth, an NG tube might be used to give nutrients. It can also be used to give medications, which can be really helpful in some medical situations.

Placement of NG Tube

An NG tube will be placed by a healthcare professional, such as a physician or a nurse, and it's typically done in the hospital. It might be done while a patient is asleep (sedated), but it is often done when the patient is awake. Local sedation of the nostrils with lidocaine or an anesthetic spray might be used.

The NG tube is inserted up through the nostrils and down through the esophagus and into the stomach. The patient is usually told to swallow while the NG tube is being placed. The procedure is uncomfortable, but it shouldn't be painful (that could indicate that the tube is not placed properly).

After the tube is in, the healthcare team will check to make sure it's in the right place and everything has gone as it should. One way of doing this is by taking an X-ray, which will show the placement of the tube.

Another way is by using the tube to add or remove some stomach contents, which can show that the tube is properly placed in the stomach. The outside of the tube will be taped down in place on the skin so that it doesn't become dislodged accidentally.

Potential Problems

NG tubes can be very effective at treating some conditions and in administering medications, but they're not without the potential for some less-than-desirable effects. People with an NG tube might experience some symptoms such as diarrhea, nausea, vomiting, abdominal cramps, or swelling.

Risks

While most NG tubes are placed without any incident, there are some risks. One of the things that can happen while the tube is being inserted is an injury to the esophagus, throat, sinuses, or stomach. It's possible that if an NG tube gets blocked or torn, or if it comes out of place, there can be further problems.

There's also a possibility for any food or medicine being put through the tube to be regurgitated or to go into the lungs (aspirated). The healthcare professionals who place nasogastric tubes are trained to be on the lookout for any potential complications.

What an NG Tube Feels Like

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, such as with an intestinal blockage.

It is uncomfortable, but it shouldn't be painful. 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.

Frequently Asked Questions

  • How long can an NG tube be left in place?

    It depends. Some tubes may need to be replaced every three days, while long-term nasogastric tubes can be left in place for four to six weeks after being inserted.

  • Is a nasogastric tube the same thing as a feeding tube?

    Yes. A primary use for an NG tube is to provide enteral nutrition, which is also known as gastric feeding.

  • Can a nasogastric tube make it hard to talk?

    Only if it isn't positioned properly and interferes with the functioning of the larynx (vocal cords). In this case, a person may sound hoarse. Once the tube is repositioned, the voice should sound normal.

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