Nasogastric (NG) Tubes: Types, Uses, and Why Your Doctor Might Say You Need One

It’s easy to take for granted that everything you swallow will travel to the stomach, start digesting, and move into the bowels. But this process is actually pretty complex. And when there are problems along this pathway, having a nasogastric (NG) tube can help. 

An NG tube can be used temporarily to treat certain conditions or as a tool to enhance nutrition. Let’s take a closer look at what an NG tube is, when it is used, and the complications to watch out for if you need to have one placed.

How do nasogastric tubes work?

An NG tube is a flexible tube that goes all the way from the nose into the stomach. It’s long enough that even though one end sits in the stomach, the other end is able to come out of the nostril. 

The NG tube end coming out of the nose can be used to suction the stomach or to give medications and nutrition directly into the stomach.

NG tubes are not a long-term solution. They are typically only used for up to 4 to 6 weeks. Using an NG tube longer than that can cause complications.

What are the different kinds of nasogastric (NG) tubes?

There are different types of NG tubes based on what they are being used for. NG tubes used for feeding or giving medications have a smaller diameter. They are made of flexible materials like silicone or latex. 

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NG tubes that are used for suctioning are usually made of plastic. They have to be wide and firm enough that they won’t collapse when suction is applied. They may be made of a single tube (Dobhoff or Levin tube) or two tubes (Salem Sump). These tubes can also be used to give medications and nutrition, but they tend to have more risk of causing damage and aren’t often used for this. 

Some healthcare providers use the term “NG tube” for any type of tube going from the nose to the stomach. Other providers may only use the term “NG tube” for the tubes that are used to suction the stomach, and they will call the thinner flexible tubes “feeding tubes.” Ask your healthcare team to clarify which kind of tube they are recommending.

How is a nasogastric tube different from other types of gastric tubes?

Orogastric (OG) tubes are inserted into the mouth (rather than the nose) and go into the stomach. They are more often used in people with basal skull fractures, in people getting anesthesia during surgery, and in kids. Like NG tubes, OG tubes are also temporary. 

For people who need more long-term access to the stomach, a PEG (percutaneous endoscopic gastrostomy) tube or G-tube (gastric tube) can be used. These go directly through the abdominal wall and into the stomach. They can stay in place for months. 

How is a nasogastric tube inserted?

Most of the time, an NG tube can be safely placed by nursing staff at the bedside. You don’t need to have any sedation. Here’s what you should expect when having an NG tube placed:

1. You should be upright in bed. It’s a good idea to protect your gown or clothes with a towel or basin, since there can be some gagging or even vomiting. 

2. The staff may spray your nose and throat with numbing medications. This is to reduce any pain or discomfort during the process.

3. They’ll also use a lubricating jelly on the tip of the tube or in the nostril directly and start advancing the tube into your nose. 

4. Once they see the tube in the back of the throat, they’ll ask you to tilt your head forward and swallow some sips of water while they keep advancing the NG tube. This helps the tube go down into the esophagus (the food pipe) rather than the trachea (the windpipe).

5. After they advance the tube to where it’s believed that the tip is in the stomach, the NG tube will need to be secured in place where it enters the nose. This is most commonly done with special tape. 

6. The staff will then need to confirm proper placement with a chest X-ray before anyone starts to use the tube. 

7. Nursing staff will continue to periodically check the tube position to see if it has either slipped out or accidentally gone further down.

In some cases, an NG tube cannot be placed at the bedside. A specialist — like a gastroenterologist or otolaryngologist — can place it using advanced imaging techniques.

When are nasogastric tubes used?

There are many different reasons your provider may suggest an NG tube. Some situations where an NG tube may be used include:

• Emptying the stomach if you have a blockage or your bowels aren’t moving properly

• Giving medications or artificial nutrition when you can’t swallow properly

• Giving activated charcoal in some cases of poisoning or toxic ingestion

• Checking stomach contents for bleeding

• Keeping the stomach empty during procedures to prevent vomiting and aspiration

There are some cases in which NG tubes should be avoided. These include:

• Severe trauma of the mouth, face, or base of the skull

• Blockage in the mouth, throat, or esophagus

• Structural issue in the esophagus (like diverticula or erosions)

• Bleeding disorders

What are the risks and complications of using a nasogastric tube?

There are several risks associated with getting an NG tube. One of the more feared complications is having the NG tube placed inside of the trachea rather than the esophagus. This would mistakenly place it in the airways and can lead to: 

• Lung infection

• Hemorrhage in the lungs or airway

• Pneumothorax 

• Sepsis 

An NG tube in an improper position can end up in the lungs or coiled up inside the esophagus. An abdominal or chest X-ray is the most common way to confirm placement. 

Other risks of having an NG tube include: 

• Aspiration pneumonia (lung infection caused by items from your mouth or stomach going into your lungs)

• Worsening of existing neck injuries during NG tube placement

• Forming holes in the nose, throat, esophagus, or stomach

• Tracheoesophageal fistula (connection formed between the windpipe and esophagus)

• Sinus and ear infection

• Mistaken placement of the NG tube in the intracranial space (area near the brain)

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Written by:

Mala Mandyam Sanchez, MD

Dr. Sanchez is a board-certified internal medicine physician. She went to the University of California, San Francisco, for medical school and completed both her residency and chief residency at Stanford University.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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