About the NG feeding tube
The NG tube is a thin, flexible tube that passes through the nostril, down the oesophagus (food pipe) and into the stomach. It allows liquid food and water to be fed directly into the stomach. We can also use the NG tube to give medicines directly into the stomach.
The use of an NG tube is usually temporary, but it can be in place for up to 3 months. If it is needed for longer than 3 months, we replace it.
Why you need an NG tube
There are many reasons why you may need an NG tube. Usually, patients who need an NG tube are unable to eat or drink enough (or cannot eat or drink at all). This means they cannot meet their body’s nutrition and hydration needs by mouth.
Sometimes we place an NG tube in advance because we know a particular treatment or illness is likely to cause problems with eating and drinking.
We will not proceed with NG tube placement unless we have your verbal consent. If you are unable to provide consent, we will talk to your next of kin.
If you decide you do not want an NG tube, we will support your decision.
Alternatives to an NG tube
If you decide you do not want to have an NG tube, there may be other options. These will depend on your personal circumstances and medical condition.
Your doctor and other healthcare professionals will discuss these options with you.
Important information
If you decide you do not want to have an NG tube, you may be unable to eat and drink enough. This means you will lose weight and become malnourished (lacking enough food) and/or dehydrated. This can affect your ability to cope with your medical treatment, delay recovery and be dangerous to your health.
Your doctor or healthcare professional can discuss this with you.
Inserting the NG tube
If at any time you want the procedure to stop, you can make an agreed signal (such as raising your hand) to let your healthcare professional know that you want them to stop.
The insertion procedure takes a few minutes.
We usually insert the tube while you are on a hospital ward. Occasionally we do this in the Kingston Hospital Radiology or Endoscopy department. If we need you to go to a specific department to have the NG tube inserted, we will discuss this with you.
To insert the tube, we apply a small amount of lubricating gel to the tip of the tube. We insert the tube into your nostril and gently pass it down your oesophagus (food pipe) and into your stomach.
Discomfort during insertion
The insertion procedure may be uncomfortable, especially when the NG tube first enters your nostril and passes down your throat.
The healthcare professional who inserts the tube will keep you informed and give advice on how you can help the tube pass easily. For example, they may ask you to try to swallow, to help the tube to pass into your stomach.
Confirming the tube is correctly placed
Once we have inserted the tube, we tape it to your nose and/or cheek.
We always confirm that the NG tube is in the correct position before we use it.
To confirm the position, we will use a syringe to take some fluid from the NG tube to test its acidity. If the pH result is too high (alkaline), or if we cannot withdraw any fluid, we will X-ray your chest to check the NG tube tip is correctly placed in your stomach.
Eating and drinking with an NG tube
It is possible to eat and drink with an NG tube in place.
Your doctor or healthcare professional will advise whether you can eat and drink with the NG tube.
How long the NG tube stays in place
The length of time the tube stays in place will depend on your individual needs. We will only leave the tube in place for as long as it is needed.
For example, we will remove the tube if:
- you are safely eating and drinking by mouth
- you are now eating and drinking enough without the tube
- you no longer need alternative forms of nutrition
- you decide you no longer want the NG tube.
Removing the NG tube
We can remove the NG tube at your bedside. To do this, we remove the tape from your nose and cheek and pull the tube gently until it is out. This may cause you to retch, cough or vomit.
If you prefer to remove the tube yourself, a healthcare professional will show you how to do this safely.
Risks and complications
Important
Most people with NG tubes are aware of the tube, especially when swallowing or coughing.
Let us know immediately if:
- You feel pain or discomfort from the tube.
- Your tube is falling out, either partly or completely.
- You notice a change in smell from your mouth or nose.
- Your sensation of the tube changes, for example when swallowing or coughing.
Common temporary risks during insertion include:
- discomfort
- gagging
- vomiting
- nosebleed.
Rare complications that can occur during insertion:
- trauma to the lining of your nasal passage, throat, or oesophagus
- oesophageal perforation (puncturing of the food pipe)
- pneumothorax (punctured lung). Due to the closeness of the oesophagus to the trachea (windpipe) there is a risk that we may place the NG tube into the airway or lung.
We will monitor you closely throughout. If any complications arise, we will manage them promptly and keep you fully informed.
Possible complications after insertion include the following.
The NG tube can become blocked
If this happens, we will try to unblock the tube at your bedside. Sometimes we need to replace it.
You can accidentally pull the NG tube out
Let us know immediately if you notice your tube is accidentally coming out (either partly or fully). You may notice the tape on your nose or cheek peeling off, allowing the tube to move. If we are feeding you via a pump, we will need to stop the feed and check the position of the tube. If necessary, we may need to insert a new tube (with your consent).
The tip of the NG tube can move into your food pipe
The tip of the tube can move into your oesophagus (food pipe). This can make you vomit and cause food to enter your lungs. If this happens we will manage it promptly. We check the external length of the NG tube frequently for signs of movement. We also observe you for retching, violent coughing or suctioning, as these can make your NG tube move internally.
The NG tube can damage your nose or food pipe
The tube can cause a sore nose or pressure damage to the tissue in your nose or oesophagus. We monitor the areas of your nose in contact with the NG tube and tape, to check for pressure damage and soreness. We change the tape regularly to review your skin underneath and monitor for allergies to the tape.
