Gastric decompression is a medical procedure designed to remove unwanted contents from the stomach. It involves introducing a tube to drain accumulated air, fluids, or other substances. Its primary aim is to relieve symptoms such as nausea, vomiting, and abdominal distension. This process allows the digestive system to rest and recover when its normal function is impaired.
Reasons for Gastric Decompression
Gastric decompression is used when the stomach or intestines cannot function properly. Common reasons include bowel obstruction, where a blockage prevents the normal passage of food and fluid, leading to buildup. It is also used for ileus, a temporary lack of normal muscle contractions in the intestines, which can occur after major surgery or due to certain illnesses.
The procedure helps prevent aspiration, a serious complication where stomach contents enter the lungs, especially in patients experiencing severe nausea or vomiting. By removing stomach contents, gastric decompression reduces the risk of vomiting and potential aspiration pneumonia. It also prepares patients for certain surgical procedures or manages gastrointestinal bleeding by removing blood. Additionally, it helps rest the gastrointestinal tract, promoting healing and allowing normal bowel function to resume.
How Gastric Decompression is Performed
The most common method involves inserting a nasogastric (NG) tube, a thin, flexible tube, through the nostril, down the esophagus, and into the stomach. Before insertion, healthcare professionals measure the tube from the patient’s nose to the earlobe, then to the breastbone, to determine the correct length. The tube tip is lubricated with a water-soluble gel for easier passage.
During insertion, the patient is typically positioned upright and may be asked to swallow sips of water to guide the tube and prevent it from entering the airway. Once in the stomach, placement is confirmed, often by X-ray, before connecting to suction or a drainage bag. The NG tube removes air and fluids, either by gravity drainage or suction. It is typically a short-term measure, removed once normal bowel function returns, usually within days to weeks.
Potential Risks and Complications
While generally a safe procedure, gastric decompression carries some potential risks and complications. Patients may experience discomfort during NG tube insertion, including pressure in the nose and throat. Common side effects include throat irritation, nasal irritation, and nosebleeds. The tube can also cause pressure ulcers in the nostril if not properly secured or left in place for extended periods.
More serious, though less common, complications can occur. There is a risk of inadvertently inserting the tube into the airway instead of the esophagus, leading to coughing, gagging, or aspiration. Prolonged NG tube use can irritate the stomach lining, potentially causing gastrointestinal bleeding or electrolyte imbalances like low potassium. Tube displacement or obstruction can also occur, requiring re-insertion or adjustment.
Recovery and Aftercare
Once the medical condition improves, the nasogastric tube is typically removed. Healthcare providers assess signs of returning bowel function, such as passing gas or a bowel movement, and decreased abdominal distention, to determine the appropriate time for removal. The removal process is generally quick and straightforward, involving the nurse detaching the securement device and gently pulling the tube out while the patient holds their breath.
Following tube removal, patients are advised to refrain from eating or drinking for about two hours to minimize leakage and allow the throat to recover. Dietary progression then begins with clear liquids, gradually advancing to soft foods and a regular diet as tolerated. Monitoring for lingering discomfort, nausea, or abdominal issues is important, and patients should report any concerning symptoms to their healthcare team.