A nasogastric (NG) tube is a thin, flexible tube inserted through the nose, down the esophagus, and into the stomach. Healthcare providers use it to deliver nutrition and medication or to remove fluids and air from the stomach. Understanding the physical sensations associated with the NG tube process can help reduce anxiety. This description addresses the physical experience from initial placement through daily life and removal.
The Sensation During Insertion
The insertion process begins with pressure and fullness as the lubricated tube is advanced through the nasal passage. The initial feeling is mechanical resistance against the nasal mucosa, often described as a sharp, brief pain or intense tickle. This sensation gives way to profound discomfort as the tube reaches the nasopharynx, the area behind the nose and above the soft palate.
The most intense part of the experience occurs when the tube descends past the back of the throat, strongly activating the body’s natural gag reflex. Patients are encouraged to swallow small sips of water or saliva as the tube is advanced to help guide it past the pharynx and into the esophagus. Swallowing closes the epiglottis, which helps prevent the tube from entering the trachea and guides it toward the stomach.
While the sensation is highly unpleasant and can trigger coughing or retching, the acute part of the procedure is very fast, often lasting only seconds to a few minutes. Once the tube has passed into the esophagus and reached the stomach, the sharp discomfort subsides. This leaves a feeling of internal pressure or a fleeting burning sensation in the upper chest. If significant resistance or sharp pain is felt, communicate this immediately, as it can indicate the tube is curling in the mouth or entering the airway.
Living with the Tube in Place
Once the NG tube is secured, the acute pain of insertion is replaced by sustained, chronic irritation. In the nasal cavity, the tube causes constant pressure against the nostril wall, which can lead to localized soreness, dryness, or minor nosebleeds (epistaxis) from friction. The tube partially blocks one side, forcing the patient to breathe more through the mouth, resulting in persistent dryness of the mouth and throat.
The most noticeable ongoing sensation is felt in the throat and esophagus, where the tube creates a persistent feeling of a foreign body or a mild sore throat. The irritation can make simple actions like swallowing saliva or speaking difficult and uncomfortable. Many patients limit talking or swallowing to minimize the movement of the tube against the pharyngeal tissues.
Within the stomach, the sensation depends on the tube’s function. If connected to suction, some patients report mild cramping or emptiness due to continuous drainage. When the tube is used for feeding, the rapid infusion of formula or fluid can cause feelings of fullness, bloating, or abdominal discomfort. The liquid passing through the tube can sometimes be felt as a cold sensation in the throat as it travels toward the stomach.
How Removal Feels
The removal of an NG tube is a faster and less distressing experience compared to insertion. Removal is described as feeling like a quick, forceful tickle or a fast rush of air and mucus passing through the nose. The entire process takes only a few seconds.
Before removal, the provider clears the tube by inserting a small amount of air to prevent aspiration. The patient is instructed to take a deep breath and hold it. Holding the breath closes the vocal cords, which helps prevent gastric residue on the tube from entering the airway as it is withdrawn.
The main sensation of discomfort occurs as the tube passes quickly back through the throat and nasal cavity, causing a brief, intense gag reflex or a tickling sensation. Some individuals report a slight burning feeling as the tube exits, likely due to stomach acid residue irritating the mucosal lining. This discomfort is immediately followed by a profound sense of relief once the tube is completely out.
Techniques for Minimizing Discomfort
Several strategies minimize discomfort, beginning with insertion. Topical anesthetics like lidocaine gel or spray can be administered to the nasal passage and back of the throat to numb the area, reducing the initial sharp sensation and the gag reflex. Taking slow, deep breaths through the mouth during insertion can help keep the body relaxed.
To manage chronic irritation while the tube is in place, meticulous oral and nasal care is recommended. Regularly rinsing the mouth with water or mouthwash, or sucking on ice chips, can alleviate the persistent dryness caused by mouth breathing.
Applying a water-soluble lubricant to the nostril where the tube exits can help soothe the irritation and prevent pressure ulcers or nosebleeds. Securely anchoring the tube to the nose prevents excessive movement, which is a major source of chronic discomfort against the nasal lining.