Nasogastric tube

Okay, here's a weird thought: I saw an article discussing a fad diet where people will get a nasogastric tube (tube down the nose into the stomach) for 10 days and consume a low-calorie protein slurry instead of eating. The idea being that you'll quickly induce ketosis and lose a lot of weight.

Now, I'm not really interested in weight loss, and this seems to be a bad approach for that, at least technically if not morally. However, I'm wondering if there might be long-term applications, allowing you to not have to eat. According to people on the diet, they don't get hungry; bypassing the mouth seems to reduce (even eliminate) hunger.

To be clear, there are a lot of concerns. Long-term use of nasogastric tubes can cause tissue damage, ulcers, and unpleasant discomfort. You'd also have to carry around a pump with the food (slurry). Also, I'm not sure what the long-term impact of cutting fiber out of your diet might be. On top of all of that, I often enjoy food, and I'm not sure if it would still be possible to eat with it installed.

So I guess I'm just wondering if anyone has attempted this, has put any serious thought into doing something like this, or really just what people think of it as a general concept.

Comments

  • Please don’t.

    Apart from all the tissue damage and discomfort (while I haven’t experience it, it is bad enough that palliative patients would rather die than to have it), your body actually do need nutrients and not feeling the need to eat is a receipe for malnutrition.

  • The way you handle it psychologically would be interesting too. Going from eating daily to never eating could really mess up some pathways in the brain.

  • > @IvoTheSquire said:
    > Please don’t.
    >
    > Apart from all the tissue damage and discomfort (while I haven’t experience it, it is bad enough that palliative patients would rather die than to have it), your body actually do need nutrients and not feeling the need to eat is a receipe for malnutrition.

    I want to clarify: first, I have no immediate plans to do this, and second, any future plan would be built around improving nutritional intake. I don't want to be malnourished, nor am I looking to diet.
  • @mercrutio said:
    > @IvoTheSquire said:
    > Please don’t.
    >
    > Apart from all the tissue damage and discomfort (while I haven’t experience it, it is bad enough that palliative patients would rather die than to have it), your body actually do need nutrients and not feeling the need to eat is a receipe for malnutrition.

    I want to clarify: first, I have no immediate plans to do this, and second, any future plan would be built around improving nutritional intake. I don't want to be malnourished, nor am I looking to diet.

    Yeah, but my point is that hunger is a good indication and drive to get nourishment - removing that might end up you forgetting to intake food and become malnourished since you won’t be feeling anything.

  • @IvoTheSquire I see, that makes sense. I wonder if the sense of hunger would really disappear if you weren't getting the right nutrient load? Clearly it's lessened, since it functions as an "easy" diet, but I imagine the body would figure it out before it got too bad? I guess that's one aspect of what @Nwilde1590 is thinking about.

  • Since eating is a primal instinct, it might be impossible to “forget” how to be hungry. Meaning even after fasting for several years you could go straight back to a normal eating cycle. The hypothalamus controls hunger and is located in the core of your brain. That would make it less flexible than say, the cortex which deals with memory storage and learning.
  • NG tubes aren't that big a deal. It's easy to do and care for. You don't need a pump. You can do bolus feedings with a large syringe. It's an easy thing to play with. I've placed them in myself a number of times. The important part is getting placement right. When intubating people, you sometime end up putting the NG tube in the wrong spot, like in the lungs. There's far less risk in someone who's conscious. Generally, placement is confirmed by X-ray. You can instead confirm it by drawing out some fluids and checking the pH. Alternatively, you can try to check placement by injecting air and auscultating with a stethoscope... It's really not a great way to do it especially if you aren't experienced.
    If you have any questions let me know. I've done myself and to others hundreds of times.
  • @Cassox said:
    NG tubes aren't that big a deal. It's easy to do and care for. You don't need a pump. You can do bolus feedings with a large syringe. It's an easy thing to play with. I've placed them in myself a number of times. The important part is getting placement right. When intubating people, you sometime end up putting the NG tube in the wrong spot, like in the lungs. There's far less risk in someone who's conscious. Generally, placement is confirmed by X-ray. You can instead confirm it by drawing out some fluids and checking the pH. Alternatively, you can try to check placement by injecting air and auscultating with a stethoscope... It's really not a great way to do it especially if you aren't experienced.
    If you have any questions let me know. I've done myself and to others hundreds of times.

    Interesting, because I’ve seen so many NGTs in hospitals and most of them they get taken out asap due to the discomfort and side effects. There are patients who utterly would refuse one even in the face of death (it’s written in their advanced health directive - a legal document in Australia declaring what they want and don’t want doctors to do to them when they’re so sick that they lack capacity).

  • @IvoTheSquire I'm wondering if what you're talking about is more about quality of life/independence/not wanting to be a "vegetable" for hospital patients, where @Cassox's experience is more with biohackers and others interested in modifying themselves.

    I mean, if there was a "quality of life"-type reason to install rfid chips in very ill patients (maybe to make access to doors, wheelchairs, etc. easier? I'm just making this up.) how many do you think would reject it because of stigma and/or the discomfort of installation? I'm guessing the number would be high.

    Again, to be clear, I really don't know what the level of discomfort or other dangers are with an NG tube, I've never had one. I'm just trying to understand the difference between what @Cassox and @IvoTheSquire have experienced.

    @Cassox, what did you primarily use the NG tubes for? Diet control? Circumventing eating? Something else?

  • No. It's most often used in intubated patients to suction out secretions. However, they're also used in situations like small bowel obstruction where the person is fully conscious. I'm not saying it's comfy, but it's not that bad.
  • This discussion hasn't been active for a while but I feel like I should say something about this because I've been living with Nasogastric (NG) and Nasojejunal (NJ) tubes for years. I also have a port so I can be fed through my heart when I don't tolerate feeds and need extra fluids. I have a more permanent feeding tube now, a GJ tube. I have these devices because my stomach and intestines are paralyzed and I have other chronic illnesses. These devices can kill you. I've been put in the ICU countless times with septic shock, twisted intestines, and internal bleeding. It's not worth it. Also, NG/NJ (you have to go to Interventional Radiology to have NJ tubes placed) tubes don't allow your esophageal sphincter to close, this will give you constant reflux and you'll throw up in your mouth when you eat. They will make your nose bleed and after a few months, they'll rip your septum. They are only meant for people with illnesses who have constant medical attention and can be monitored. I don't have a choice and I wish I did, it's not fun. So to anyone thinking of getting a feeding tube, please please don't, they're not some fun little device so you don't have to eat.

  • An NJ is whole different beast. An Ng or Og though is usually pretty harmless.. assuming a short duration. But yeah.. they aren't pleasant long term. They aren't really meant to stay in that long. They'll usually go in through the abdominal wall. They sent you home with an ng in place?
  • Why haven't they just placed a basic gastric tube?
  • I have the GJ tube now (the tube through my abdominal wall). But it took a long time to get it because its permanent and my doctors needed to figure out what was wrong with me before they started doing more surgeries. After a few years of traveling to get diagnosed my doctors decided to place the GJ tube. I still can't live with just the GJ tube because of the gastrointestinal paralysis so most of my nutrition gets fed through my Portacath.

  • Crazy. Parenteral nutrition is like Biosphere II. People don't seem to get that it doesnt work. I've never seen anyone thrive on TPN. How does it work? How often do you see a nutritionist? Do you run your own fluids? Do you take lipids and protein?
  • Yeah, I've been living on TPN on and off ever since I was born and it's a lifesaver. I see my nutritionist and gastroenterologist every month to make adjustments to the TPN. My nurse comes over once a week to check my vitamin levels, platelets, everything. I access my port myself, it's supposed to run 24/7. But being hooked up to an IV bag all the time isn't realistic so I just run it in the mornings and at night. And yeah, it's lipids, all the vitamins I need, and saline. It's pretty much just one massive bag of everything I need to keep me alive.

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