This leaflet contains important advice about your x-ray guided nasogastric (NG) or nasojejunal (NJ) insertion. It will explain what is involved and what the possible risks are.
We hope you find this information helpful, but you should still discuss any concerns you have with your doctor before you come for the procedure.
What is a NG/NJ insertion and why do I need one?
A nasogastric (NG) tube is a feeding tube ending within your stomach. A nasojejunal (NJ) tube is a feeding tube ending in the jejunum (part of the small bowel).
These tubes are usually required when you are unable to meet nutritional requirements through physically eating food, and therefore require assistance. This is usually a decision made by a multi-disciplinary team including doctors, dieticians, nutrition nurses and speech and language therapists.
How long you will stay in hospital?
Most patients can have this procedure done as an outpatient and can go home straight after.
If this is your first feeding tube, you may need to stay in hospital for up to 2 hours after your procedure. This is to allow the dieticians to speak to you about the next steps in your feeding regime.
** On rare occasions an overnight stay may be required, but this will be communicated to you by your referring team.
What are the risks and complications?
An x-ray guided insertion of a feeding tube is a safe procedure and serious complications are rare.
Despite these small risks your consultant has decided to refer you for this examination. This is because they feel that the benefits of having the procedure outweigh the risks. Your consultant will discuss your options with you.
Radiation - This procedure uses x-rays to help the specialist doctors navigate the tubes into the correct place. The doctor or advanced practitioners are specially trained in using x-rays and will only use them when needed. The radiation will always be kept as low as reasonably possible. Please tell a member of staff if you think you could be pregnant.
The main risks include the following:
- Discomfort or mild pain during the insertion process
- Bleeding at the back of the nose which is rare
- Misplacement of the tube or unable to correctly place the tube
The following are rare risks and complications:
- Bowel perforation
- Pneumothorax
- Aspiration
If you have any worries, please do not hesitate to discuss possible complications with hospital staff.
How do I prepare for the tube insertion?
Most patients can have this procedure done as an outpatient and can go home straight after.
If this is your first feeding tube, you may need to stay in hospital for up to 2 hours after your procedure. This is to allow the dieticians to speak to you about the next steps in your feeding regime.
** On rare occasions an overnight stay may be required, but this will be communicated to you by your referring team.
Anticoagulant medication
You do not need to stop any anticoagulation medication for this procedure.
What happens during a feeding tube insertion?
Insertion of a feeding tube involves placing a small polyurethane tube down either of your nostrils, down your oesophagus (food pipe) and into your stomach (NG) or further down into your small bowel (NJ). The type of tube will be decided by your referring team and will depend on your nutritional requirements and medical history.
The feeding tube has a thin wire within it during placement to allow the practitioner to steer and move the tube into the stomach or small bowel. The practitioner will use live x-rays (fluoroscopy) to guide the tube into the correct place.
The tube is ideally secured using a bridle device where possible. This is a piece of string/silicone that loops around the back of your nasal passage and clips to the tube. If this is not possible to place, or too uncomfortable, the tube can be secured with tape.
What happens after?
If you have not already received training in all aspects of tube feeding, tube care and the administration of medication via the feeding tube please contact your dietician.
At home
At home, please follow the below advice to ensure the maintenance of your feeding tube:
Fixation device – this needs to be checked daily. If using a plaster this can be changed when loose or soiled.
Skin care – cleansing the face should be carried out as per individual routine.
Mouth care – teeth should be cleansed as per individual routine and followed with mouthwash if required. Dentures should be cleaned as normal. During this, check the tube is not coiled at the back of the throat.
Tube flushing – the tube should be regularly flushed to maintain patency. Please follow dietician’s advice/regime.
Enteral feeding – ENFit giving set should be changed every 24 hours and any remaining feed discarded.
Tube position – make a note of the measurement on the tube after placement, if this changes, please let your dietician know. This could be an indication the tube needs repositioning or replacing.
What if I decide not to have the procedure?
If you decide not to go ahead with the procedure after you have had a chance to discuss any concerns you have with the radiologist, we will notify your referring doctor of your decision so that they can discuss any further options with you.
What if I cannot attend my appointment?
If you have any queries about your appointment or cannot attend, then please telephone the booking office:
Salford Royal Hospital - 0161 204 2044/2404 (Monday to Friday 8am to 4pm)
Royal Oldham Hospital - 0161 656 1178 (Monday to Friday 8.30am to 4pm)
You can also email booking.radiology@nca.nhs.uk (Salford Royal Hospital) or ir.bookingsOldham@nca.nhs.uk (Royal Oldham Hospital).
Please include name, date of birth, address and hospital number (if known) in any correspondence.
Please help us to cut our waiting lists. If you need to cancel or chance your appointment, call us as soon as you can, so that we can give it to another patient.
Interpreters
If you need an interpreter for your examination and/or procedure. This can be either verbal non-English language or non-verbal British sign language, Makaton etc.
Please call the department so that we can try and arrange this.
There is also information about interpretation services on the back of this leaflet.
If I need an ambulance, how do I arrange this?
If you need an ambulance there are contact details on your appointment letter. Please inform the department, using the contact details in this leaflet if you are arriving by ambulance.
Contact Details
We hope your questions have been answered by this leaflet.
If you require help or any other information regarding your appointment you can contact:
The Angiography Department, Salford Royal Hospital
Tel: 0161 206 2206/5091
Interventional Radiology, Royal Oldham Hospital
Tel: 0161 778 5314/5414
Date of Review: July 2025
Date of Next Review: July 2027
Ref No: PI_DP_2119 (NCA)