Nasogastric and nasoenteric tubes
- Richard A Hodin, MD
Richard A Hodin, MD
- Professor of Surgery
- Harvard Medical School
- Liliana Bordeianou, MD, MPH
Liliana Bordeianou, MD, MPH
- Assistant Professor of Surgery
- Harvard Medical School
Nasogastric and nasoenteric tubes are flexible double or single lumen tubes that are passed proximally from the nose distally into the stomach or small bowel. Enteric tubes that will be removed within a short period of time can also be passed through the mouth (orogastric). This topic will review the indications, contraindications, placement, management and complications of nasogastric and nasoenteric tubes.
The management of postoperative ileus and bowel obstruction are discussed elsewhere. (See "Postoperative ileus" and "Overview of management of mechanical small bowel obstruction in adults".)
Nasogastric tubes are indicated for the following reasons:
●Treatment of ileus or bowel obstruction – Gastrointestinal decompression using nasogastric tubes is important for the treatment of patients with bowel obstruction or prolonged ileus. Nasogastric decompression improves patient discomfort, minimizes or prevents recurrent vomiting, and serves as means to monitor the progress or resolution of these conditions. (See "Postoperative ileus" and "Overview of management of mechanical small bowel obstruction in adults".)
●Administration of medications – A nasogastric tube may be needed to administer medications, or oral contrast for computed tomography, to patients who cannot swallow or who are neurologically impaired.
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- TYPES OF TUBES
- AREAS OF CONTROVERSY
- Prophylactic placement
- Gastric lavage
- Enteral nutrition
- TUBE PLACEMENT
- Placement for decompression
- - Alert patient
- - Intubated patient
- Placement for feeding
- Confirmation of placement
- Clinical confirmation
- Tube fixation
- Nasal alar ulceration or necrosis
- SUMMARY AND RECOMMENDATIONS