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 "Small bowel obstruction: Causes and management".)
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 "Small bowel obstruction: Causes and management".)
- 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.
- Enteral nutrition – Nasogastric and nasoenteric tubes are used to deliver enteral nutrition into the stomach (gastric feeding) or into the small intestine (post-pyloric). (See 'Enteral nutrition' below.)
- Stomach lavage – Lavage may be needed to remove blood or clots to facilitate endoscopy. (See 'Gastric lavage' below.)
Contraindications — Nasogastric intubation is contraindicated in patients with esophageal stricture because of the risk for esophageal perforation, and in patients with basilar skull fracture or facial fracture due to the potential for intracranial misplacement [1,2].