From the Guidelines
Patients with a nasogastric (NG) tube can eat by mouth in certain circumstances, but this depends on their specific medical condition and the reason for the NG tube placement, with the goal of minimizing morbidity, mortality, and improving quality of life. The decision to allow oral intake in patients with an NG tube should be made on a case-by-case basis, taking into account the patient's swallowing ability and the risk of aspiration 1. If the NG tube is being used for gastric decompression or suction, eating is typically not allowed as the tube is removing stomach contents. However, if the NG tube is being used only for medication administration or supplemental feeding, and the patient has adequate swallowing function, they may be permitted to eat.
Before attempting oral intake, patients should have their swallowing ability assessed by a healthcare provider, usually through a swallow evaluation, such as the Toronto Bedside Swallowing Screening test 1. When eating is permitted, patients should start with small amounts of soft foods and liquids, avoiding foods that are difficult to chew or swallow. They should eat slowly and remain upright for at least 30 minutes after eating to reduce the risk of aspiration. The presence of the NG tube may cause some discomfort during eating and can affect taste sensation. Patients should report any increased pain, nausea, vomiting, or difficulty breathing while eating, as these may indicate complications requiring immediate medical attention.
It is essential to note that the risk of aspiration pneumonia is not eliminated by the use of an NG tube 1, and therefore, careful assessment and monitoring of the patient's condition are necessary to minimize this risk. The Feed or Ordinary Diet (FOOD) trials have shown that early NG tube feeding may substantially decrease the risk of death and result in better functional outcomes 1, highlighting the importance of adequate nutrition in patients with stroke. By allowing patients with an NG tube to eat by mouth when possible, healthcare providers can help improve their quality of life, reduce morbidity, and minimize mortality.
From the Research
Nasogastric Tube Feeding
- Nasogastric (NG) tube feeding is a common method for delivering nutrition to patients who are unable to consume food orally 2.
- NG tubes can be used to provide a nutritionally adequate diet, bypassing the oral route, and are often used in patients with dysphagia or other conditions that make eating difficult 3.
- The management of NG feeding requires standardization, and education for nurses is essential to ensure that this intervention is carried out safely, effectively, and acceptably 3.
Patient Eating with NG Tube
- There is no direct evidence to suggest that patients with an NG tube cannot eat, but the tube is often used when patients are unable to consume adequate oral intake 4.
- In some cases, patients may be able to eat while having an NG tube, but this depends on the individual patient's condition and the purpose of the NG tube 5.
- The decision to allow a patient to eat with an NG tube should be made on a case-by-case basis, taking into account the patient's nutritional needs and the risk of aspiration or other complications 6.
Nursing Practices
- Nursing practices related to NG tube feeding and medication administration can vary widely, and there is a need for further research to standardize these practices 6.
- A multidisciplinary approach is essential in ensuring that patients with NG tubes receive safe and effective care, including nutrition and medication management 5.
- Nurses play a central role in caring for patients with NG tubes, and education and training are essential to ensure that they have the necessary skills and knowledge to provide high-quality care 2, 3.