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Nasogastric and nasoenteric tubes

Richard A Hodin, MD
Liliana Bordeianou, MD, MPH
Section Editor
Hilary Sanfey, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


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 comfort, minimizes or prevents recurrent vomiting, and serves as a 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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Literature review current through: Nov 2017. | This topic last updated: Jul 24, 2017.
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  1. Ferreras J, Junquera LM, García-Consuegra L. Intracranial placement of a nasogastric tube after severe craniofacial trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90:564.
  2. Başkaya MK. Inadvertent intracranial placement of a nasogastric tube in patients with head injuries. Surg Neurol 1999; 52:426.
  3. AL, L. A new gastroduodenal catheter. JAMA 1921; 76:1007.
  4. Nelson R, Tse B, Edwards S. Systematic review of prophylactic nasogastric decompression after abdominal operations. Br J Surg 2005; 92:673.
  5. Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database Syst Rev 2007; :CD004929.
  6. Inman BA, Harel F, Tiguert R, et al. Routine nasogastric tubes are not required following cystectomy with urinary diversion: a comparative analysis of 430 patients. J Urol 2003; 170:1888.
  7. Otchy DP, Wolff BG, van Heerden JA, et al. Does the avoidance of nasogastric decompression following elective abdominal colorectal surgery affect the incidence of incisional hernia? Results of a prospective, randomized trial. Dis Colon Rectum 1995; 38:604.
  8. Yang Z, Zheng Q, Wang Z. Meta-analysis of the need for nasogastric or nasojejunal decompression after gastrectomy for gastric cancer. Br J Surg 2008; 95:809.
  9. Daryaei P, Vaghef Davari F, Mir M, et al. Omission of nasogastric tube application in postoperative care of esophagectomy. World J Surg 2009; 33:773.
  10. Rao W, Zhang X, Zhang J, et al. The role of nasogastric tube in decompression after elective colon and rectum surgery: a meta-analysis. Int J Colorectal Dis 2011; 26:423.
  11. Kunstman JW, Klemen ND, Fonseca AL, et al. Nasogastric drainage may be unnecessary after pancreaticoduodenectomy: a comparison of routine vs selective decompression. J Am Coll Surg 2013; 217:481.
  12. Cheatham ML, Chapman WC, Key SP, Sawyers JL. A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy. Ann Surg 1995; 221:469.
  13. Dennis M, Lewis S, Cranswick G, et al. FOOD: a multicentre randomised trial evaluating feeding policies in patients admitted to hospital with a recent stroke. Health Technol Assess 2006; 10:iii.
  14. Kelly G, Lee P. Nasendoscopically-assisted placement of a nasogastric feeding tube. J Laryngol Otol 1999; 113:839.
  15. Ellett ML. What is known about methods of correctly placing gastric tubes in adults and children. Gastroenterol Nurs 2004; 27:253.
  16. Hanson RL. Predictive criteria for length of nasogastric tube insertion for tube feeding. JPEN J Parenter Enteral Nutr 1979; 3:160.
  17. Beckstrand J, Cirgin Ellett ML, McDaniel A. Predicting internal distance to the stomach for positioning nasogastric and orogastric feeding tubes in children. J Adv Nurs 2007; 59:274.
  18. Gallagher EJ. Nasogastric tubes: hard to swallow. Ann Emerg Med 2004; 44:138.
  19. Wang PC, Tseng GY, Yang HB, et al. Inadvertent tracheobronchial placement of feeding tube in a mechanically ventilated patient. J Chin Med Assoc 2008; 71:365.
  20. Mandal MC, Dolai S, Ghosh S, et al. Comparison of four techniques of nasogastric tube insertion in anaesthetised, intubated patients: A randomized controlled trial. Indian J Anaesth 2014; 58:714.
  21. Kirtania J, Ghose T, Garai D, Ray S. Esophageal guidewire-assisted nasogastric tube insertion in anesthetized and intubated patients: a prospective randomized controlled study. Anesth Analg 2012; 114:343.
  22. Baskin WN. Acute complications associated with bedside placement of feeding tubes. Nutr Clin Pract 2006; 21:40.
  23. Cohen MD, Ellett M. Quality of communication: different patterns of reporting the location of the tip of a nasogastric tube. Acad Radiol 2012; 19:651.
  24. Bennetzen LV, Håkonsen SJ, Svenningsen H, Larsen P. Diagnostic accuracy of methods used to verify nasogastric tube position in mechanically ventilated adult patients: a systematic review. JBI Database System Rev Implement Rep 2015; 13:188.
  25. Banerjee TS, Schneider HJ. Recommended method of attachment of nasogastric tubes. Ann R Coll Surg Engl 2007; 89:529.
  26. Burns SM, Martin M, Robbins V, et al. Comparison of nasogastric tube securing methods and tube types in medical intensive care patients. Am J Crit Care 1995; 4:198.
  27. McGuirt WF, Strout JJ. "How I do it"--head and neck. A targeted problem and its solution: securing of intermediate duration feeding tubes. Laryngoscope 1980; 90:2046.
  28. della Faille D, Schmelzer B, Hartoko T, et al. Securing nasogastric tubes in non-cooperative patients. Acta Otorhinolaryngol Belg 1996; 50:195.
  29. Reignier J, Mercier E, Le Gouge A, et al. Effect of not monitoring residual gastric volume on risk of ventilator-associated pneumonia in adults receiving mechanical ventilation and early enteral feeding: a randomized controlled trial. JAMA 2013; 309:249.
  30. Palta S. Nasogastric tube knotting in open heart surgery. Acta Anaesthesiol Scand 1999; 43:790.
  31. Agarwala S, Dave S, Gupta AK, Mitra DK. Duodeno-renal fistula due to a nasogastric tube in a neonate. Pediatr Surg Int 1998; 14:102.
  32. Newton M, Burnham WR, Kamm MA. Morbidity, mortality, and risk factors for esophagitis in hospital inpatients. J Clin Gastroenterol 2000; 30:264.
  33. Metheny NA, Meert KL, Clouse RE. Complications related to feeding tube placement. Curr Opin Gastroenterol 2007; 23:178.
  34. Tawfic QA, Bhakta P, Date RR, Sharma PK. Esophageal bezoar formation due to solidification of enteral feed administered through a malpositioned nasogastric tube: case report and review of the literature. Acta Anaesthesiol Taiwan 2012; 50:188.
  35. Malik NW, Timon CI, Russel J. A unique complication of primary tracheoesophageal puncture: knotting of the nasogastric tube. Otolaryngol Head Neck Surg 1999; 120:528.
  36. Lai PB, Pang PC, Chan SK, Lau WY. Necrosis of the nasal ala after improper taping of a nasogastric tube. Int J Clin Pract 2001; 55:145.