nasogastric

Nasogastric refers to the nose and stomach. In medical contexts, a nasogastric tube (NG tube) is a flexible tube inserted through a nostril, passed down the esophagus, and into the stomach to access the stomach contents or deliver therapies.

Indications include decompression of the stomach in intestinal obstruction or ileus; drainage of gastric contents after surgery or during gastrointestinal bleeding; gastric lavage in poisoning or overdose situations; administration of medications or nutrition; and sampling of gastric contents for analysis. Contraindications include facial or basal skull fractures, significant nasal trauma, or conditions where passage through the nose could worsen injury.

NG tubes are typically made of polyurethane or silicone and come in various diameters. They may be used for gastric decompression, or specialized feeding tubes (nasogastric feeding tubes) designed to deliver enteral nutrition beyond the stomach. Some tubes are single-lumen with side holes, while others are double-lumen (for example, a sump-type tube with an air vent for suction).

Insertion is performed by trained clinicians. After measuring length (from nose to earlobe to midline point near the xiphoid process), the tube is passed through a nostril into the oropharynx and esophagus into the stomach. Placement is confirmed by aspiration of gastric contents and pH testing, radiographic imaging, or other methods; the tube is then secured with tape and kept patent by periodic flushing with water. Feeding tubes require confirmation of placement before use, and medications are often given through the tube with attention to compatibility.

Complications include misplacement into the airway, which may cause coughing, respiratory distress, pneumothorax, or aspiration; nasal or pharyngeal trauma; sinusitis or otitis; esophageal or gastric injury; tube blockage or dislodgement; and rarely electrolyte or fluid disturbances if used for prolonged gastric drainage.

Alternatives include orogastric tubes (through the mouth), post-pyloric or nasojejunal tubes for feeding, and, in long-term cases, percutaneous endoscopic gastrostomy.