Nasogastric Suction

Definition

Nasogastric suction involves removing solids, liquids, or gasses from the stomach or small intestine by inserting a tube through the nose and suctioning the gastrointestinal material through the tube.

Purpose

Nasogastric suction may be done in the following situations:

• to decompress the stomach or small intestine when intestinal obstruction (ileus ) is suspected
• prior to gastrointestinal operations
• to obtain a sample of the gastric contents for analysis
• to remove toxic substances
• to flush the stomach during gastrointestinal bleeding or poisonings

Nasogastric intubation, the insertion of a tube through the nose into the stomach or small intestine, is also done to temporarily feed certain patients. In this case, material is not suctioned out.

Precautions

Nasogastric tubes cannot be placed in patients who have blockages in their esophagus, enlarged esophageal veins or arteries that might bleed, or severe damage to the jaws and face. The tube cannot be inserted in a patient who is having convulsions, or who is losing or has lost consciousness unless a tube has been inserted into his or her airway (intubation).

Description

The patient sits upright while a lubricated tube is slipped through the nose and down the throat. The patient may be asked to sip water at a certain point in the procedure to facilitate the passage of the tube. If the tube is to be placed into the small intestine, the doctor may use an endoscope to help see where the tube is going. Once the tube is in place, material can be removed from the stomach or intestines with gentle suction.

There are several different types of nasogastric tubes, each with a different purpose. Tubes used for stomach flushing are called orogastric tubes and are the largest in diameter. Tubes that are threaded through the lower opening of the stomach (pylorus) and into the small intestine are stiffer and have a balloon tip. Other specialized tubes are used for long-term and short-term feeding.

Preparation

Little preparation is necessary for this procedure other than educating the patient as to what will happen. The patient should remove dental appliances before the nasogastric tube is inserted.

Aftercare

After the tube is removed, no special care is needed. The patient's throat may feel irritated from the presence of the tube.

Risks

The most serious risk is that the patient will inhale some of the stomach contents into the lungs (aspiration). This may lead to bronchial infections and aspiration pneumonia. There is also the chance that the tube will be misplaced in the windpipe (trachea), causing violent coughing. Irritation to the throat and esophagus can cause bleeding.

Normal results

Nasogastric suctioning is normally well tolerated by patients and is a temporary treatment, performed in conjunction with other therapies.

Resources

BOOKS

Berkow, Robert, editor. "Nasogastric or Intestinal Intubation." In The Merck Manual of Diagnosis and Therapy. Rahway, NJ: Merck Research Laboratories, 2004.

KEY TERMS

Endoscope— A piece of equipment with a camera and a light source in a thin tube that can be threaded through the nose into the gastrointestinal system so that the doctor can make a real-time visual examination.

Pylorus— The ring of muscle that controls the passage of material from the stomach into the small intestine.