Why would someone need a feeding tube in their nose?

January 8, 2026 •

5 min read

According to the National Institutes of Health, over 1.2 million nasogastric feeding tubes are inserted annually in acute care settings in the United States. A person might need a feeding tube in their nose, medically known as a nasogastric tube (NGT), when they are temporarily unable to consume adequate nutrition orally due to various health issues or procedures.

Quick Summary

A nasogastric tube is used for short-term nutritional support and medication delivery when oral intake is compromised. It can also be used for gastric decompression to relieve pressure from blockages or after surgery.

Key Points

Swallowing Impairment: Neurological disorders like stroke and Parkinson's or conditions affecting the head and neck can make swallowing unsafe, necessitating a nasogastric tube (NGT) for feeding to prevent aspiration.
Gastric Decompression: NGTs can be used to remove air and fluid from the stomach, relieving pressure caused by bowel obstructions, ileus, or other GI issues.
Addressing Malnutrition: For critically ill, post-surgical, or chronically ill patients who cannot consume enough nutrients orally, an NGT provides essential nutritional support and hydration.
Short-Term Intervention: The NGT is generally a short-term solution (less than 4-6 weeks); for longer-term needs, other methods like a gastrostomy tube are considered.
Emergency Treatment: In cases of poisoning or drug overdose, an NGT allows for the rapid removal of toxic substances from the stomach.
Medication Delivery: The tube can also be used to administer medications directly into the stomach for patients unable to swallow pills.
Confirming Placement: The tube's position must be confirmed before use, typically with an X-ray, to prevent the dangerous complication of placing feeding into the lungs.
Patient Comfort and Safety: Careful monitoring, proper positioning during feeding, and good oral hygiene are crucial for managing an NGT safely and minimizing discomfort.

Core Reasons for a Nasogastric Feeding Tube

A nasogastric tube (NGT) is a flexible tube inserted through the nostril, down the esophagus, and into the stomach. It is a temporary intervention used for several critical reasons. Understanding these indications helps provide clarity during stressful medical situations. The two primary purposes are administering nourishment and medications or decompressing the stomach to remove contents.

Swallowing Difficulties (Dysphagia)

One of the most common reasons a person may need a feeding tube in their nose is dysphagia, or difficulty swallowing safely. This condition can result from a variety of causes, making it unsafe for a patient to eat or drink by mouth due to the risk of aspiration (inhaling food or liquids into the lungs). Conditions leading to dysphagia include:

Neurological disorders: Diseases like stroke, multiple sclerosis, or Parkinson's disease can impair the neuromuscular function required for proper swallowing.
Trauma: Head and neck injuries can damage the swallowing mechanism, necessitating an alternative feeding method during recovery.
Cancer: Cancers of the head and neck, or their treatments like radiation and surgery, can make swallowing painful or difficult.

Gastric Decompression

In addition to feeding, NGTs are used for stomach decompression, which involves removing air and fluid from the stomach to relieve pressure. This is a vital procedure in several medical scenarios:

Bowel obstruction or ileus: These conditions prevent the normal passage of intestinal contents, causing a buildup of fluid and gas. Decompression helps prevent nausea, vomiting, and aspiration until normal function returns.
Post-operative care: Following certain types of gastrointestinal surgery, an NGT is used to keep the stomach empty and prevent pressure on the surgical site.
Emergency procedures: In cases of drug overdose or toxic ingestion, an NGT can be used to empty the stomach quickly.

Malnutrition and Increased Nutritional Needs

Some individuals, despite having a functional digestive system, are unable to meet their daily caloric and nutritional requirements orally. A nasogastric tube provides a reliable and efficient way to deliver complete nutrition and support healing. This applies to several patient populations:

Critically ill patients: Conditions like burns, major infections (sepsis), or extensive trauma dramatically increase the body's energy demands. An NGT ensures these needs are met to aid recovery.
Infants and children: Premature babies or children with congenital issues, cystic fibrosis, or chronic illnesses may not be able to consume enough calories to grow properly and may need an NGT for a period.
Severe anorexia: Conditions such as anorexia nervosa or other psychological issues may prevent adequate oral intake, requiring temporary nutritional support.

Lists of Common Conditions and Their Impact

Neurological Conditions

Stroke: Can result in permanent or temporary loss of swallowing function, increasing aspiration risk.
Dementia: Patients with advanced dementia may lose the ability or willingness to eat and drink safely.
Parkinson's Disease: A progressive disorder that can lead to severe dysphagia.

Gastrointestinal Conditions

Inflammatory Bowel Disease (IBD): Severe cases can lead to malabsorption and malnutrition, requiring supplemental feeding.
Gastroparesis: A condition where the stomach empties very slowly, causing nausea and vomiting. An NGT can be used for decompression or for feeding if passed into the small intestine.

Critical Illness and Post-Surgery

Mechanical Ventilation: Patients on a ventilator cannot safely eat and require enteral nutrition.
Post-Surgery: After major head, neck, or abdominal surgery, an NGT may be placed to provide bowel rest and manage gastric contents.

Comparison Table: NGT vs. Other Feeding Tubes


Feature	Nasogastric Tube (NGT)	Percutaneous Endoscopic Gastrostomy (PEG)	Jejunostomy Tube (J-Tube)
Placement	Through the nose into the stomach.	Endoscopically placed directly into the stomach through the abdominal wall.	Surgically or endoscopically placed into the small intestine (jejunum).
Duration of Use	Short-term (typically less than 4-6 weeks).	Long-term (often for months or years).	Long-term.
Comfort	Can cause nasal irritation, sore throat, and discomfort.	More comfortable for long-term use as it bypasses the nasal passages.	Generally well-tolerated for long-term feeding.
Aspiration Risk	Higher risk if gastric emptying is an issue or if the patient has a poor gag reflex.	Lower risk compared to NGT.	Lower risk as feeding is delivered past the stomach.
Suitability	Best for temporary situations or emergencies where swallowing is impaired or stomach emptying is required.	Ideal for long-term feeding when the stomach can tolerate formula.	Used when the stomach cannot be used for feeding due to medical issues.

Nursing Considerations for NGT Placement and Management

The insertion and care of a nasogastric tube require careful management to ensure patient safety and comfort. This process is typically performed by trained healthcare professionals, with several steps involved to confirm proper placement and prevent complications. A key safety check involves verifying the tube's position before use, most reliably done with an X-ray. The American Association of Critical-Care Nursing recommends checking and documenting tube position every four hours and before administering feedings or medication.

Best Practices for Care:

Positioning: Keep the patient's head elevated at 30 degrees or higher during feeding and for a period afterward to minimize aspiration risk.
Tube Security: Ensure the tube is securely taped to the nose and pinned to the gown to prevent accidental dislodgement or migration.
Oral Hygiene: Provide frequent oral care to keep the mouth and throat moist, as the NGT can cause dryness and irritation.
Flushing: Flush the tube with water before and after administering formula or medication to prevent blockages.

Conclusion

A nasogastric feeding tube is a critical, though often temporary, medical tool used to provide nutrition, medication, or stomach decompression when a patient cannot do so orally. The reasons for its necessity are diverse, ranging from neurological conditions and cancer to emergency situations like poisoning or recovery from surgery. While it presents some discomfort and potential risks, proper care and monitoring ensure that the tube serves its purpose safely, supporting a patient's health and recovery. For long-term nutritional needs, a different type of feeding tube, such as a gastrostomy, may be considered. Ultimately, a multidisciplinary healthcare team determines the most suitable feeding method based on the patient's specific medical condition and prognosis.

Lists of Potential Complications

Misplacement: The most serious risk is the tube entering the respiratory tract, which can cause severe respiratory distress or pneumonia.
Discomfort: Common issues include nasal irritation, sinusitis, and sore throat.
Dislodgement: The tube can accidentally be pulled out, requiring re-insertion.
Blockages: The tube can become clogged with formula or improperly crushed medications.
Aspiration: Accidental inhalation of stomach contents into the lungs is a major risk, especially in patients with impaired swallowing.

American Gastroenterological Association (AGA) Guidelines for Enteral Nutrition

Clinical Judgment and Patient-Centered Care

The decision to insert an NGT is not made lightly and always involves a comprehensive assessment by a medical team. The benefits of ensuring proper nutrition and gastric function are weighed against the potential discomfort and risks to the patient. Especially in older adults or those with cognitive impairments, agitation can lead to a higher risk of tube dislodgement. In these cases, close monitoring and alternative securement measures, along with thorough communication with the patient and family, are essential components of care. The ultimate goal is to use the NGT as a bridge to recovery, helping the patient regain their strength and, ideally, their ability to eat normally again.

Frequently Asked Questions

A nasogastric tube (NGT) is a temporary feeding tube inserted through the nose into the stomach, typically used for less than 4-6 weeks. A Percutaneous Endoscopic Gastrostomy (PEG) tube is surgically placed directly into the stomach through the abdominal wall and is intended for long-term use.

While the insertion of an NGT can be uncomfortable and cause a brief, strange sensation, the tube is generally tolerable once in place. Minor discomfort, including nasal irritation or a sore throat, can occur during the period the tube is used.

A nasogastric tube is generally intended for short-term use, typically less than 4 to 6 weeks. For longer nutritional support, a physician will likely recommend a different type of feeding tube, such as a gastrostomy tube, which is more comfortable and durable for extended periods.

This depends on the patient's specific medical condition. If the tube is for gastric decompression, the patient may be on a 'nil by mouth' (NPO) order. However, if the tube is only for supplemental feeding and swallowing is safe, some oral intake may be permitted, but this must be confirmed by the medical team.

The most significant risk is misplacement, where the tube enters the respiratory tract instead of the stomach, which can be fatal if not identified immediately. Other risks include tube dislodgement, blockages, aspiration pneumonia, and general discomfort.

Proper placement of an NGT must be verified before each use to prevent life-threatening complications. The most reliable method is through an X-ray. Some bedside tests, like checking the pH of aspirated fluid, may also be used.

Yes, aside from the standard nasogastric tube (NGT), other variations include the nasoduodenal (ND) and nasojejunal (NJ) tubes. These are often used when the stomach cannot be used for feeding, and the tip of the tube is advanced beyond the stomach into the small intestine.

No, a nasal feeding tube is not required for all cases of malnutrition. The need for a feeding tube depends on the cause and severity of the malnutrition and whether the patient can consume enough orally. Other interventions, like oral supplements or dietary changes, may be sufficient.