The effect of nasogastric intubation on gastroesophageal reflux: a comparison of different tube sizes.

OBJECTIVE

Previous reports have revealed conflicting conclusions about whether tubes placed across the esophagogastric junction (EGJ) have promoted reflux and whether there is potential for subsequent esophageal mucosal damage. The purpose of this study was to examine whether commonly used tubes (diameters: 2.1 mm, antimony pH probe and 3.8 mm, nasogastric tube) promote reflux under typical inpatient conditions.

METHODS

Eight asymptomatic volunteers (five male, mean age 27.6 yr) underwent three sessions, each lasting 6 hours postprandially, while supine with the head elevated 20 degrees. In randomized order, the subjects had either a 2.1-mm tube, 3.8-mm tube, and 2.1-mm tube together or no tube across the EGJ. The subjects were fed 500 ml of Ensure Plus at the beginning of the study. Reflux was measured by a pH probe placed 5 cm above the lower esophageal sphincter. The number of reflux episodes, number of reflux episodes more than 5 minutes, longest reflux episode, time esophageal pH was less than 4, and percentage total time pH was less than 4 were evaluated.

RESULTS

Over the 6 hours, no abnormal reflux was shown with either tube size across the EGJ.

CONCLUSIONS

Over a 6-h period, a tube (pH probe alone or combined with nasogastric tube) across the EGJ does not promote an increase in the amount of postprandial supine gastroesophageal reflux in normal volunteers.