Kerry from the USA asks:
“I am scheduled for CRS and HIPEC. My surgeon says I will wake up from surgery with an NG tube. What can I expect to experience with the NG tube?”
Gabriella from the USA responds:
“The Nasogastric tube, or “NG tube” is plastic tubing inserted through the nose, down the throat and into the stomach. In the case of CRS and HIPEC patients, it is inserted while the patient is “asleep” under anesthesia.
In the case of CRS and HIPEC patients the NG tube is used for aspiration to suck out the patient’s stomach contents, including secretions and swallowed air from the stomach. The NG tube is attached to a drainage bag or bottle alongside the patient’s bed, for the collection of drainage contents. When used for aspiration the patient is not allowed to eat or drink anything by mouth, including popsicles, broth or gelatin. In order to prevent vomiting, it’s important for the patient to refrain from eating or drinking anything while the NG tube is in place.
For CRS and HIPEC patients, the NG tube is typically left in place for several days to a few weeks, depending on how much time is need for peristalsis to resume. The nose and throat may become irritated the longer the NG tube has been left in place. For this reason, and due to oral dryness, some patients prefer to limit speaking at length (limit the length of their conversations.)
To combat oral dryness, refer to our article “Dental Care for Cancer Patients” offering solutions to combating the oral discomfort that may accompany use of the NG tube. Although the patient is neither eating nor drinking while the NG tube is inserted, it’s very important to maintain dental hygiene during this period in order to prevent future dental decay.
During the time the NG tube is in place, the patient’s abdomen will be checked several times a day for signs (sounds) of peristalsis. Peristalsis typically slows or ceases during the initial days following CRS and HIPEC, especially when narcotics are being administered for pain relief.
When signs (sounds) of peristalsis return, the NG tube is typically removed within a day or so. As tempting it may be for the patient to remove the NG tube prematurely, a conservative approach to removing the NG tube is suggested, as should the NG tube need to be reinserted, it will most likely be done so without the use of general anesthesia. Most patients prefer to avoid re insertion, if at all possible.
After the NG tube has been removed, clear fluids are gradually introduced to the patient’s diet. Once again, it is suggested that patient’s progress conservatively in re introducing clear, followed by soft, and eventually solid foods back into the diet, in order to avoid vomiting.
Each patient should consult with his/her personal surgeon for detailed information about the use of the NG tube for the patient’s specific case.”
Articles posted in PMP Pals and on www.pmppals.org are written from the perspectives of patients and their families and are not intended to substitute for licensed, professional legal or medical advice. Each patient is unique and should seek specific counsel from their own licensed healthcare professional. Copyright © 2012 by Gabriella Graham. All rights reserved.