Key takeaways
- Always feed with the head raised at least 30–45 degrees.
- Check the tube marking at the nose before every feed.
- Flush with clean water before and after feeds and medicines.
- Coughing, choking or breathlessness during feeding — stop immediately.
What is a Ryles tube?
A Ryles tube (nasogastric or NG tube) is a thin, soft tube passed through the nose into the stomach. It is used when a patient cannot swallow safely — commonly after a stroke, in advanced dementia, in head injury, or during critical illness — so that food, fluids and medicines can be given directly into the stomach.
Before each feed
- Wash hands thoroughly and clean the work surface.
- Sit the patient up at 30–45 degrees or higher.
- Check the marking on the tube at the nostril matches the level noted by the nurse — if the tube has moved out, do not feed.
- Make sure the tube is not coiled in the mouth.
- Prepare the feed exactly as advised by the doctor or dietitian, at room temperature.
Feeding step by step
- Flush the tube with about 30 ml of clean, boiled and cooled water.
- Pour the feed into the syringe barrel and let it flow slowly by gravity — do not push forcefully.
- Keep the syringe raised slightly above the stomach level; raise or lower it to control the speed.
- Give the prescribed quantity over 15–20 minutes or as advised.
- Flush again with about 30 ml of water and close the tube cap.
- Keep the patient sitting up for 30–60 minutes after the feed.
Giving medicines through the tube
Ask the doctor or pharmacist which medicines can be crushed — some tablets must not be. Crush and dissolve each medicine separately, flush between medicines, and never mix medicines directly into the feed unless advised.
Daily tube and nose care
Clean the nostril gently and change the tape that fixes the tube daily, moving it slightly to prevent pressure sores on the nose. Clean the mouth twice a day even though the patient is not eating, to prevent infection. Ryles tubes are usually changed by a nurse at intervals depending on the type of tube.
When to stop and call for help
- Coughing, choking, or a change in breathing during feeding.
- The tube has come partly or fully out.
- Vomiting, a swollen tight abdomen, or diarrhoea that does not settle.
- The tube is blocked and does not clear with a gentle water flush.
Never try to push a displaced tube back in. A trained nurse should reinsert it and confirm its position.
Frequently asked questions
How often should a Ryles tube be changed?
It depends on the type of tube. Many standard PVC tubes are changed every 7 to 10 days, while silicone tubes can last longer. Follow the nurse’s or doctor’s advice.
Can family members give Ryles tube feeds?
Yes, after a nurse has trained them. Tube insertion and position checks after displacement should be done by a trained nurse.
What food can be given through a Ryles tube?
Commercial feeds or blended home feeds as advised by the doctor or dietitian. The feed must be smooth enough to flow without blocking the tube.
This guide is general information for families, not medical advice. Always follow your treating doctor’s instructions. In an emergency call 108 / 112.