An NG tube (nasogastric tube) is a thin, flexible plastic tube that goes through your nose, down your throat, and into your stomach. It’s one of the most common medical tubes used in hospitals, serving two main purposes: draining the stomach when it needs to be emptied, or delivering nutrition and medication when a person can’t eat or swallow normally. The tube travels roughly 40 to 45 centimeters from nostril to stomach, passing through the nasal cavity, the back of the throat, and down the full length of the esophagus.
Why NG Tubes Are Used
NG tubes fall into two broad categories based on what they’re doing inside your body.
The first is decompression, which means removing air, fluid, or stomach contents. This is common after abdominal surgery or when the intestines have slowed down or become blocked (a condition called an ileus or bowel obstruction). In these situations, the stomach keeps producing fluid with nowhere for it to go, causing pain, bloating, and nausea. The NG tube connects to gentle suction that drains the buildup and relieves pressure.
The second purpose is feeding and medication delivery. When someone can’t safely swallow, whether from a stroke, severe illness, surgery on the mouth or throat, or prolonged time on a ventilator, an NG tube provides a direct route to the stomach. Liquid nutrition, water, and crushed medications can all be given through the tube. For people who need tube feeding for only a short period (days to a few weeks), an NG tube is typically the first option before considering a more permanent tube placed directly through the abdominal wall.
How the Tube Is Placed
Before insertion, a healthcare provider measures the tube to estimate how far it needs to go. The standard technique, called the nose-earlobe-xiphoid method (NEX), involves measuring the distance from the tip of the nose to the earlobe, then from the earlobe down to the bottom of the breastbone. This gives a rough estimate of the total length needed to reach the stomach. The tip of the tube should sit about 10 centimeters below the diaphragm to ensure it’s well inside the stomach and not lingering in the esophagus.
During insertion, you’re usually sitting upright or with your head slightly tilted forward. The lubricated tube enters one nostril, slides along the floor of the nasal cavity, curves down the back of the throat, and passes into the esophagus. You’ll be asked to swallow sips of water as the tube passes the throat, which helps guide it into the esophagus rather than the airway. The whole process typically takes just a few minutes.
Once the tube is in place, the team needs to confirm it’s actually in the stomach and hasn’t accidentally gone into the lungs. The most reliable bedside method is testing a small sample of fluid drawn through the tube. Stomach fluid is acidic, so a pH reading of 5.5 or below generally confirms correct placement. However, certain medications (particularly antacids) can alter stomach pH, so results sometimes need to be interpreted carefully. An X-ray is used when there’s any doubt.
What It Feels Like
There’s no sugarcoating it: having an NG tube placed is uncomfortable. Most people describe a steady, pressing pain as the tube moves through the nostril and a strong urge to gag or swallow as it passes the back of the throat. You can feel the tube traveling down, and the sensation of a foreign object in the throat triggers an instinct to either swallow hard or try to push it out. The insertion itself is brief, but those few minutes can feel much longer.
Once the tube is secured, the worst of the sensation fades, but it doesn’t disappear entirely. The most persistent discomfort tends to be a pricking or irritation inside the nostril where the tube sits, especially noticeable when you move your face, talk, eat, or swallow. One patient described spending the first couple of hours trying not to move at all because any facial movement made the nose pain worse. Over time, most people adjust to the feeling, though awareness of the tube in the throat can linger.
Removal is generally much easier than insertion. Patients consistently report that having the tube pulled out is quick and far less uncomfortable than having it put in.
Tube Sizes
NG tubes are measured in French gauge, where each unit equals about one-third of a millimeter in diameter. Adults typically use tubes in the 14 to 18 French range, while children use smaller sizes matched to their age and weight. Infants under six months old usually get an 8 French tube, toddlers move up to 10 or 12, and older children may use a 12 French tube. Smaller tubes are more comfortable but can clog more easily; larger tubes drain more effectively but cause more irritation in the nose and throat.
Possible Complications
Most NG tubes work without serious problems, but complications can happen. The most common issues are mild: sore throat, nasal irritation, and discomfort while the tube is in place. The tube can also cause minor nosebleeds or irritation to the lining of the esophagus, especially if it stays in for an extended period.
The most serious risk is aspiration, which means stomach contents or tube-fed liquid enters the lungs. In people receiving nutrition through a feeding tube, aspiration pneumonia has been reported at widely varying rates depending on the patient population, with a mortality rate between 17% and 62% in those who develop it. This is why head-of-bed elevation (keeping the upper body raised at least 30 degrees) and regular checks on tube position are standard practice during tube feeding.
In rare cases, the tube can be accidentally placed into the airway instead of the esophagus, which is why placement verification is a critical step before anything is given through the tube. There’s also a small risk of the tube eroding the tissue inside the nose or throat if left in place for weeks, which is one reason longer-term feeding needs are usually managed with a different type of tube.
Living With an NG Tube
If you’re going home with an NG tube or spending days in the hospital with one, a few practical realities come with it. The tube is taped to your nose and sometimes your cheek to keep it from shifting. You’ll need to be careful not to accidentally pull on it when changing clothes, sleeping, or moving around. The tape needs regular replacement to prevent skin breakdown on the nose.
Eating and drinking with an NG tube in place is possible in many cases, but it feels strange. The sensation of swallowing around the tube takes getting used to, and some people find it unpleasant enough that they prefer to minimize eating by mouth while the tube is in. Dry mouth and throat irritation are common, and ice chips or small sips of water can help.
Tubes used for feeding need regular flushing with water to prevent clogging, particularly before and after medication is given or feeding sessions. If the tube becomes blocked, it may need to be replaced, which means going through insertion again. Keeping the tube flushed on schedule is one of the simplest ways to avoid that.
How Long NG Tubes Stay In
An NG tube for stomach decompression after surgery might only be needed for a day or two. For feeding, it could stay in for several weeks. Most guidelines suggest that if tube feeding is expected to be needed for longer than four to six weeks, a gastrostomy tube (placed directly through the skin into the stomach) is a better long-term option. Gastrostomy tubes avoid the ongoing nasal and throat irritation that comes with an NG tube and are easier to manage over months or years.