Does NG tube make reflux worse
Nasogastric (NG) tubes can be easily displaced. If you are concerned the tube is not in the stomach and/or the pH strip indicates a reading of more than 5.5, do not put anything down the tube. In this situation, please read the troubleshooting section of this information or seek advice from your healthcare professional. Show
Before discharge from hospitalBefore you are discharged with an NG tube, you should have discussed the topics outlined in this leaflet with your healthcare professional. Confirming the correct position of your NG tubeIt is important to check your NG tube is in the correct position to reduce the risk of feed or water from entering your lungs. This is because it may cause a chest infection or serious harm. You always need to check the position of your NG tube before you do any of the below:
Additionally, the position of the NG tube should be checked any time you feel the position of the tube may have moved, for example after a coughing spasm, vomiting, retching, difficulty in breathing or reflux. If the tube has moved it may appear longer, have fallen out of the nose or be coiled in the throat. How to check the tube’s positionBefore you begin, think about whether there is a reason to suspect the tube has moved out of the stomach.
If you cannot pull back aspirate from your NG tubeTry one or more of the following:
Flushing your NG tubeIf you are not using your NG tube for feeding, make sure you flush the tube at least once a day with fresh tap water to reduce the risk of the tube blocking. Please contact your dietitian to advise you on the amount of water required. Method for flushing your NG tubePlease only do this after you have confirmed the tube is in the correct position.
There are then two options to flush the tube. Option one
Option two
When flushing your tube, you may wish to try to avoid emptying the tube completely by kinking the end of the tube before removing the syringe or as the last drops of water are entering the tube. This can reduce the risk of air entering your stomach which can make you feel uncomfortable and bloated. Try to remain upright for at least 30 minutes after a feed or flush to help prevent reflux and regurgitation. The syringes can be washed according to instructions or, when time to do so, can be disposed in your normal household waste. Feeding via an NG tubeWhen feeding, please sit or lay in an upright or semi-upright position – at a 30 to 45-degree angle. Always flush the tube with water before and after giving any feed or medication. This reduces the risk of the tube blocking. Your dietitian will tell you how much water and feed to use as part of your feeding plan. Caring for your tube and skin
If your skin becomes sore or irritated, contact your community nurse or GP for advice. Troubleshooting tipsIf you have learned how to pass the NG tube yourself you might want to refer back to your proficiency documents. What if my tube becomes blocked?The most common causes for feeding tubes to become blocked are feed or medications. The following tips can help clear a feeding tube which has become blocked with feed or medications: Milking the tube Push and pull technique Soda water If you think the tube is blocked by medication, check your technique and process for administering medications or ask your nurse to check with you. If it’s a persistent problem and you are following the correct procedures for administering medicines, your GP might be able to review your medication if an alternative is available. What if I still can’t get any aspirate to check the position of my tube before feeding?It remains vital that you obtain aspirate from the nasogastric tube and you test it using pH paper and you obtain a pH of 5.5 or below before you commence feeding via the tube. If you still cannot get any aspirate from the tube you might be able to:
If you are still unable to obtain aspirate, contact your nurse or the contact given when you first came home with your tube, to discuss a way forward. What if I can get aspirate from the tube but the pH is six or above?It is possible for the pH of your stomach to be higher than 5.5. This can be caused by some medications, or the presence of feed or food. It can feel very frustrating when you want to feed but the aspirate pH is six or above. However, it remains vital that you obtain aspirate from the nasogastric tube, you test it using pH paper and you obtain a pH of 5.5 or below before you commence feeding via the tube. If you have just placed the tube and you want to use it for water, feeding or medication for the first time follow the procedure for replacing a nasogastric tube. In some circumstances, with a tube that has been confirmed as being in the correct position on previous occasions you may be able to follow a different process. Your dietitian or nurse may give you additional training and additional information about what to do when the pH of an existing, correctly placed tube is high. What do I do if my nasogastric tube comes out?If your nasogastric tube comes partially or fully out when you are not feeding through it, remove it, the securing tape, and discard as you would normally. If you are feeding when your tube comes out it is possible that the tube has dislodged and gradually worked its way out and therefore you may have inadvertently got feed in your wind pipe or lungs. If you feel unwell or are concerned, you must obtain medical advice. Your feeding tube will probably need replacing. If you have been taught how to do this, you may go ahead if you have passed the NG proficiency assessment. If you do not replace your own nasogastric tube you should contact the person, ward, or children’s community nurse, as agreed when you were discharged from hospital. If the tube has come out during the night and you are not concerned you have inadvertently got feed into your windpipe, it is possible for some people to leave the tube replacement until the morning. Agree a plan with your doctor, nurse or dietitian so you are prepared if this happens. The plan will vary from person to person depending on your age, condition and/or treatment plan. What should I do if the tape securing the tube starts to peel off?
What if I still need help?If you still need help with your nasogastric feeding, contact the Abbott or Nutricia. Alternatively, contact your designated contact, community nurses or the Home Enteral Nutrition Service for advice. Does NG tube help with reflux?Previous studies have shown that nasogastric tubes have no significant effect on the incidence of gastroesophageal reflux or on lower esophageal sphincter pressure in healthy volunteers.
Can you have reflux on a feeding tube?Conclusions: Gastroesophageal reflux and aspiration in patients fed via the gastrostomy tube may be caused by LES relaxation secondary to gastric distention caused by distention of the stomach.
What are the complications of NG tube?The most common complications related to the placement of nasogastric tubes are discomfort, sinusitis, or epistaxis, all of which typically resolve spontaneously with the removal of the nasogastric tube.
Does NG tube irritate throat?The sore throat is usually mild and gets better with time. If there are no other reasons why your child cannot eat or drink (e.g. they have a problem with swallowing), then your child can eat and drink with the tube in place. This might be the case if they have the NGT for medicines only.
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