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36 replies

Ng tube in and how long before I feel better

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J jeaneMember
Yes..this should help you. Your situation is not uncommon. As I indicated I had the same issue but was able to avoid the NG tube as when they inserted (two attempts), the residents could not get it in and I refused a third attempt and told them I did not need them to help me throw up that I was having a fine time on my own doing it.

Each time they tried to insert it I vomited.
Once I did that, my ileus seemed to resolve the next day. I never had the rectal tube but I assume they are trying to avoid an obstruction and keep things from blocking up on both ends.

I know this is frightening. You will make it through it, I know it is very painful
Last edited by jeane
CTBarristerCTBarristerMember
Sandrine,

I had postsurgical ileus too. NG inserted while I was in the act of vomiting, and forced down my nose by a brutal but effective resident at Mount Sinai Hospital. It made me feel better. It was in for 24 hours in my case. They should spray your throat with an anesthetic so you don't feel like gagging because it is a weird sensation. Eventually peristalsis will return and when it does the tube will be removed.

The NG tube is to remove the bile and keep you from throwing up, pending the return of normal peristalsis enabling normal processing of digestive fluids. You will be shocked by the amount of digestive fluids your body produces but don't concern yourself with it. The rectal tube is probably to monitor the return of peristalsis. It will happen and then the tube comes out. Should not be too long.

I know it's easier said than done but try to relax, many of us have been through this. This is a "war story" you can tell to later generations when they ask your advice down the road.

Good luck!
Last edited by CTBarrister
K KatieOMember
Yes, the NG tube will help. I had it for 3 days. The worst part for me was having it put in. It sure felt better than throwing up every ten minutes. DJBHusky is right, you will be shocked by the amount of fluid that you're body will produce, but just know that the more that comes out, the closer you are to getting rid of the tube. Good luck to you and you are definitely not alone!
S SandrineVMember
Thanks everyone. This Is extremely hard for me, just like it had been for you. I just hope it's over soon. My doc came in and told me he would probably take it out on Wed. (To late for me) but I don't want to have to do this again. He said my function should come back, but there is a small chance I have An abscess that isn't showing up on scan. I hope not. Any other info Is always helpful. Thanks
CTBarristerCTBarristerMember
Sandrine,

Hang in there, your function will come back. You are correct that it's better to leave it in until Wednesday, and check out the possible abscess (which may put you in the Karbear camp of having a problem due to swelling or inflammation rather than ileus??????). No need to have them take it out and then re-insert which would not be fun.

Try to relax as much as possible, get some sleep if you can, and perhaps listen to music.

Let us know what happens and best wishes for a speedy recovery!
SpookySpookyMember
The NG tube remains a very unpleasant memory. I feel your pain. I needed one two different times; they had so much trouble getting it in on one occasion that they had to bring up a pediatric tube, and my surgeon ultimately was the only one who could put it in. I've also gagged one up, necessitating the torment of putting it in again.

That said, as horrible as the tube is, the alternative of constantly vomiting up bile is far worse. I've never felt sicker in my life than when I had my two full obstuctions (one due to ileus, the other to inflammation/swelling). When the tube went in, I still felt crappy, but at least the nausea improved and I stopped vomiting. It was a welcome relief.

I needed the tube for about 3 days, then it came out and I could have water and gingerale. You'll get there!
CTBarristerCTBarristerMember
Spooky,

I remember you posting once before about the pediatric NG tube. I did some research on it and you are correct that there is such a thing. When I had my NG tube insertion experience (fortunately only once), which was back in 1992, I took a look at it and thought there was no way it could fit in my nose. I have a teeny tiny nose and teeny tiny nostrils.

I actually had a somewhat comical argument with my attending resident about this. He was a doctor with 20 years experience in Russia who was forced into a re-do on residency when he came to the USA. He seemed like he had a chip on his shoulder. We argued about whether he would get the NG tube in.

Me (between vomit wretches): "Dude, there is no way you are getting that tube in me. It's too big!"

Doc (with evil grin, think Laurence Olivier in "The Marathon Man"): "Dude, one size fits all!!!!!"

I then resisted and he physically overpowered me and got the tube down my nose forcibly, but professionally and painlessly. He clearly had done this before.

It was 1992 and I suspect it was "one size fits all" at that time, and they have since realized some noses are smaller than others and invented the pediatric NG tube. Just in time for you Spooky! Medical science always is moving forward. Unfortunately, my nose had to endure the bigger "one size fits all" NG tube of 1992. The Cro-magnon days.
SpookySpookyMember
DJBHusky,

I know for a fact that there definitely is a pediatric one (at least circa 2005 and again in 2007 when I needed it) because the nurses made a special request to the peds ward for it after almost an hour of failed attempts with the standard one. I was on a morphine drip at the time but I'm sure I didn't imagine that. *LOL*

Anyway, I'm sure there are occasions when infants require one. I can't imagine putting a standard size tube in a baby or toddler. BTW, I'm petite myself; 5'3" and I have small nostrils as well. I distinctly remember the standard tube hitting the back of my nostril and the nurse saying that she was getting resistence and it wouldn't fit. In the end, 3 nurses tried, including a male nurse who was a "my way or the highway" type and he couldn't get it in either. It was then that they made the call for the peds size, and my surgeon himself brought it up and inserted it pretty much in one go. Oh well. I'd be happy to never need one again.
CTBarristerCTBarristerMember
quote:
I was on a morphine drip at the time but I'm sure I didn't imagine that. *LOL*


Yes, like I said you are correct. I did research on it and they do have it. Until I read your post, for nearly 20 years I had always believed it was "one size fits all", based on what I had been told back in 1992. Because my nose has not gotten any bigger since then, I was concerned in the event I ever needed another NG tube. It's good information to know for those of us with small noses and nostrils, and I will request a pediatric NG tube should the need for one ever arise again (I hope not).
SpookySpookyMember
Yeah, 20 years ago that may have been the case, but it's definitely good to know there are options now. If I ever need another NG tube (and I can only hope that it's never again) I would request the pediatric tube even before they tried with the standard size. There is no way I'm going through that torment again.
CTBarristerCTBarristerMember
quote:
I refuse to ever have a NG tube


Refusal was not an option for me. When you are vomiting heavily for hours on end, severe dehydration is going to happen if you are not intubated. I attempted physical resistance and I was physically overpowered by the Doctor.

If you are in the situation where you have an ileus and you are vomiting and cannot stop, it's best to have the NG tube even if you may dread the thought (as do all of us who have had it).
Jan DollarJan DollarModerator, RN, retired
Not to burst anyone's bubble of hope, but often, a pediatric NG tube does not suffice. There needs to be enough space for more than liquids to come out, otherwise it is clogging all the time. Plus, there is an additional channel for air to come in, so that the tube does not just suck up to the side of your stomach. Smaller tubes are also more difficult to pass because they are softer and tend to coil at the back of the throat.

My surgeon probably thought I was a glutton for punishment, but when he came in announcing he was pulling my NG tube, I asked him to try leaving in place for one more day, but clamped, instead of attached to suction. If I could tolerate it clamped for 24 hours, then I was ready to have it out. He agreed and it worked out fine. That was the way we did it in the surgical ICU I had worked in. It is always traumatic to have to reinsert those things.

Jan Smiler
SpookySpookyMember
I guess I was fortunate that in my case, the pediatric tube worked. The thing is, I was vomiting and in distress and desperately needed a tube, 3 people tried an hour and nobody could insert it. I wasn't really fighting it either, it just would not fit; the nurse encountered resistance and did not want to force it down. So they went with plan B, which was the smaller size. However, as I mentioned, I'm petite so for me, a smaller tube was an option and functioned effectively. I don't recall problems with clogging. The only issue I had was gagging up the tube, which necessitated it being reinserted, but I'm not sure that had to do with size, as much as the fact that I kept being moved around for scans/room changes at the time and I think the movement jostled it around. But I understand that a smaller one probably wouldn't be ideal for everyone, especially for taller or larger individuals.

I would think that with a gastric tube being far more invasive, most doctors would opt for the NG tube first. But recovery times may be different for BCIR and perhaps and NG tube isn't as effective.
CTBarristerCTBarristerMember
Spooky,

Fidgeting and jostling of the NG tube will definitely cause a gag reflex. That is why it is important to try to relax. I hope Sandrine is doing that but we have no update on her condition.

By the ways, I think that the issue you had in getting the "adult" size NG tube inserted may have had something to do with lack of skill and/or aggression by the intubators. My intubator was a Doctor. I think the nurses were probably freaked out by trying to insert an NG tube on a patient who was actively and very precipitously vomiting with 40 staples in his adbomen, so they went and got him. In addition to having to overpower me to get the tube down, I was amazed at how quickly and painlessly he did get it down, through my small nostril which seemed to me of insufficient width to accomodate the tube. The insertion process was over with quickly, although it took them a while to subdue me, as I was behaving like Arnold did in this scene from the movie "Total Recall":

http://www.youtube.com/watch?v=RtoJBv-YHUo
SpookySpookyMember
DJBHusky,

I don't necessarily disagree. If I listed all the ways I initially misdiagnosed, undertreated, sent home (even once scolded by an ER physician for "wasting ER time"), ignored, etc,etc, in the course of my medical journey, I'd have written a novel. So, perhaps somebody more skilled could have gotten me properly intubated. The point is, at the end of the day, they got a tube inserted when I was in significant distress and when it was absolutely necessary that something be done to relieve the problem. I also agree that I probably shouldn't have been moved so much right after being intubated. It had nothing to do with me not being "relaxed." My surgeon wanted to send me down for x-rays, and then due to circumstances beyond the staff's control, I had to move rooms. In and out of wheelchairs, on and off gurneys, wasn't conducive to keeping still.

At least I wasn't fighting the tube. Smiler

As with anything, hindsight is always 20/20.
S SandrineVMember
Hi everyone,
Guess what I'm home after 9 days in the hospital. The NG tube stayed in for 48 hours. I thought my life was over and was having so many regrets about surgery. However, you were all right Patience and time is what I needed. I already started to have somewhat formed stool. My Dr recommended a low residue diet. I know that's good, but I'm afraid I will get stopped up. Do u think I should add fiber? I am going to bathroom around 15 times. I am just so scared I'll get an ileus again? Is that possible?
CTBarristerCTBarristerMember
Hi Sandrine,

Glad to hear you are on the road to recovery. The NG tube is a nasty experience but now it is just a war story for the IBD "treasure chest" of experiences. Frowner

If you had a post operative ileus and peristalsis has returned, the chances of getting another ileus is unlikely. Blockages, however, are still a possibility as you could have adhesions and scar tissue from surgery that can create a recipe for a blockage. Probably no way to prevent these either (if caused by adhesions or scar tissue as opposed to inappropriate diet). I had a few blockages after takedown, due to adhesions, but none in the 20 years since. If you have a blockage you will feel an extreme knotted up feeling and need to go to the ER immediately.

If you are having 15 BMs per day you should be okay. Take the low residue diet and see how you do with it. If you persist with this amount of BMs you can talk with the Doctor about bulking agents, fiber, imodium or anti-spasmodics, but it is probably way too early for that as you may experience improvement with the natural healing process and the low residue diet.
Last edited by CTBarrister
V vashtaneradaMember
Sorry im replying to such an old message but im new to the forum. I've had crohns since 2004 when i had my first small bowel obstruction and needed my 1st NG tube. It was attempted to be put in place by a 4th year medical student at the LGI hospital, Leeds, UK and I too have a small nose and she faffed around for half an hour till I'd filled s basin with bile and my nose was bleeding and I was crying and on the verge of swearing... i told her i wouldn't have it, go away, worst still, I'm from a family of nervous gigglers so my Brother was stood there chewing his fingernails and laughing awkwardly af my misery throughout...
2 hours later, a tiny male nurse from Vietnam came and told me what a doylum the doctor was and said I must have the tube or risk bowel rupture and peritonitis but he promised me hd would have it down in less than a minute, could I trust him...? He sprayed my throat with local and put KY jelly up my nostril, sat me bolt upright against the wall with a glass of water, another nurse holding my forehead firm to the wall and literally threw the thing up my nose and down telling me to swallow constantly. It was in and aspirating bile within 30 seconds..
My advice is to get a long term gastric nurse to perform this procedure, follow the above instructions and, the relief is incredible. Throwing up bile and/or ones own fecal matter is not an experience for anyone, trust me. Many doctors give up these so called simple procedures once they qualify and hand it down to those beneath them for practice whereas for gastric nurses, it's bread and butter work, I've had 8 NG tubes now and always pick a nurse every time, the oldest and kindest, if possible. The longest I had one in was 12wks when I had MRSA and my left nostril is scarred where the tube ulcerated the flesh, I was so used to it, so ill and it was taped up so I didn't even notice it hurting until time for it to come out. Good luck to you all with GI problems, I feel for you.
MysticobraMysticobraMember
I had the tube twice. Apparently my surgeon was very experienced at it.... Just have to remember to swallow the water they give you while inserting it fast and it will go right down. I had no problem either time doing it and it was the only time in my life I have had it done. It was a great relief immediately as my stomach was full and it was gushing gunk out right away. The tube was a huge relief. I think if they tell you you are getting it and don't do it right away the time to think it over stresses people. Gotta remember no matter how bad it is to get the tube it will help. I would do it again no problem if I had to.
CTBarristerCTBarristerMember
Rachel,

I probably wouldn't mind you putting an NG tube down on me if you used the pediatric sized NG tube, but that 50-something Russian resident with the proverbial "chip on his shoulder" is just what I needed at that time. He had something to prove. There was a certain anger I could feel emanating from his being. It's exactly what I needed at that point in time, vomiting uncontrollably, and resisting due to ignorance and not knowing better. Nurses are generally too compassionate. I think that is why they passed on me. I needed someone with zero compassion and 100% ruthlessness at that point in time in my life. That guy was in the right place at the right time, maybe not for his career, but for me as a patient. And just like at certain other moments in my life, it all worked out for me. It was luck. I also got lucky with my surgeon too. And my nurses. And my parents.
C CeeeeCeeeeMember
I had my first and only experience with an NG tube while dealing with a small bowel obstruction. The nurse who inserted it was a wonderful "therapist" in that she convinced me she had been chosen by my surgeon to do the procedure because she was so good at it! Actually, she was wonderful! A real cheerleader working little by little and cheering me on all the way. Once it was in I didn't mind having it at all as long as I was careful not to tug on it by mistake. That seemed to happen because I'd forget I had it in! Anyway, it was well worth the relief it furnished me!
J JaypeaMember
I had an ileus post op from my j-pouch. I was in agony and vomiting and although the insertion was an absolute nightmare the relief I felt immediately when 500cc's of bile poured out of the tube was amazing. The relief lasted only about an hour or so and the next 6 days until my bowel woke up were horrible. I know it was a necessary evil but I hated it. They let me suck on ice chips and cough candies which helped. Make sure that your bowel function is back and that you are tolerating fluids for at least 24 hours before they take it out.
T TaiMember

Why was I vomiting profusely when I had a NG tube in, even the Dr's were baffle by this?

the vomit was dark green or brownish in color, this was all bile.  Was in the hospital for 10 days with a intestinal full blockage  on the 3rd day was going to put some kind of barium in the ng tube but because i was vomiting so much they were unable to do so for fear if i were to vomit with the barium, it would go into my lung and told it was life threating  so they gave me ativan to help with the gaging and vomit and would try it again the next day, the ativan did help to a point where they were able to do the scan to see how much blockage i had, well needless to say it could only show a bit but Dr said they could no longer wait and preceeded with the surgery.  Turn out I had a total blockage in my intestine which had like a tight rubber squeezing it.  Dr was able to do it laparoscopic because too much adhesions which probally caused all the problem.  By the 9 th day tube came out and was able to eat a liquid diet which was fine by me.....after nothing to eat or drink for 10 days!

On the 10th day i was able to go home, i have been home 10 days now and am feeling pain for the last  7 days, my stomach is distended but not like before we call my Dr office and the nurse said if its on going to go to the Er,  I will not let them put the Ng tube again so I will wait 3 days to see my surgeon, hopefully its just part of the healing process.

Last edited by Tai
Jan DollarJan DollarModerator, RN, retired

It is unusual for vomiting to continue in spite of the NG tube. I can assure you that the tube was not the cause. It was the complete obstruction. I am glad that they finally went ahead with the surgery.

Please do go to the ER if your pain escalates or you begin vomiting again. It is possible that they missed some bad ahesions. Sometimes they cannot bisualize all they need to laparoscopically.

Jan

BP bob pMember

I had the colectomy 6 months ago and just had a successful takedown 10 days ago. I've been in the hospital for 10 days and still haven't bm. last week I had an ng put in for my distension, hiccups and vomiting. since then i've had some vomiting 1 to 3 times a day, but they wouldn't remove the ng (7 days) until I sneezed and it came out. today is the best I've felt so far and got close to a bm a few times, just waiting for that. they know I won't let them put the ng back in, unless I get sick again.

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