Michael, 42 y.o. The man is admitted to the med-surg floor with a diagnosis of acute pancreatitis. His BP is 136/76, pulse 96, Resps 22, and temp 101. His past history includes hyperlipidemia and alcohol abuse. The doctor prescribes an NG tube. Before inserting the tube, you explain the purpose to the patient. Which of the following is the most accurate explanation?
A. “It empties the stomach of fluids and gas.”
B. “It prevents spasms at the sphincter of Oddi.”
C. “It prevents air from forming in the small intestine and large intestine.”
D. “It removes bile from the gallbladder.”
Correct Answer: A. “It empties the stomach of fluids and gas.”
An NG tube is inserted into the patient’s stomach to drain fluid and gas. Nasogastric tubes are part of the standard of care in treating intestinal obstruction and can also be used to provide nutritional support. They are most common in surgical patients but are useful in any patient population where gastric decompression or nutritional support is necessary.
Option B: An NGT does not prevent spasms at the sphincter of Oddi. The most common indication for placement of a nasogastric tube is to decompress the stomach in the setting of distal obstruction. Small bowel obstruction from adhesions or hernias, ileus, obstructing neoplasms, volvulus, intussusception, and many other causes may block the normal passage of bodily fluids such as salivary, gastric, hepatobiliary, and enteric secretions.
Option C: Similarly, intractable nausea or emesis, whether caused by medications, intoxication, or other reasons, can be an indication for the placement of a nasogastric tube in order to prevent aspiration. Prophylactic placement of the NG tube in patients with abdominal surgery is not recommended. Patients who develop postoperative ileus tend to recover faster without the placement of an NG tube.
Option D: Placement of an NGT does not remove bile from the gallbladder. NG tubes have been used for various reasons in patients with GI bleeding. In the past, NG lavage was thought to help control GI bleeding. However, recent studies have shown that this is not helpful. Another indication for placement of a nasogastric tube is in the setting of massive hematochezia.
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