Nasogastric (NG) Tubes and IBD

A nasogastric (NG) tube is a flexible rubber or plastic tube that is passed through the nose, down through the esophagus, and into the stomach. The tube is temporarily placed in order to deliver substances to or remove them from the stomach.

It's most commonly used to deliver liquid nutrition directly to the stomach because a person is unable to eat enough for their body's needs, though there are other uses.

This article explains reasons why you may need an NG tube, how the tube is inserted, and possible complications that you should be prepared for.

Illustration showing the nasal cavity

Leonello Calvetti / Science Photo Library / Getty Images

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. 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 (this is a dye that helps differentiate structures so they can be better viewed on scans)
  • Protecting the bowel after surgery or during bowel rest

People with inflammatory bowel disease (IBD) sometimes need to have an NG tube placed, especially if they are hospitalized. In some cases, an NG tube is used to treat an intestinal blockage associated with IBD without having surgery.

An NG tube is usually automatically inserted after abdominal surgery of any kind. However, research shows that an NG tube is not always needed.

Before having surgery, check whether your doctor anticipates any circumstances or complications that could require you to need an NG tube. 

Recap

An NG tube is a temporary treatment that allows substances to be added or removed from the stomach. It allows nutrients, medication, or imaging contrast to be delivered directly into your digestive system. It may also be used to protect your bowels.

How Is an NG Tube Placed?

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. 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.

Recap

The tube is inserted through the nose, down your throat, and into your stomach. You will likely be awake during this process. A numbing medication may be given to reduce discomfort.

Risks

NG tubes can be very effective at treating some conditions and delivering medications, but they may also cause some problems. People with an NG tube might experience a variety of complications such as nausea, vomiting, abdominal cramps, or swelling.

Diarrhea

The most 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.

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 (hollow cavities in the head), or stomach.

While placement of an NG tube is most commonly done 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 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 up to 82% of patients who receive an NG feeding tube. The risk of this is especially great 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 people with an NG feeding tube.

Recap

NG tubes can cause diarrhea or injury. They can also move out of position or cause substances to enter the lungs, leading to pneumonia.

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 is a common way to treat an intestinal blockage for those with IBD and enables doctors to feed and provide certain medications to people temporarily unable to swallow anything. It can 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 circumstance with your doctor.

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.

  • 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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9 Sources
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