Effect of nasogastric tube decompression on symptom relief in patients with small bowel obstruction: a prospective multicenter observational study
Alexandra Munteanu, Johanna Berg, Erik Ferry, Per Sandström, Ulf Ekelund, Lina Holmqvist, Mazdak Tavoly, Jens WretbornAbstract
Introduction
Nasogastric tube (NGT) decompression is widely used in the non-operative management of small bowel obstruction (SBO) to relieve symptoms. However, its effect on pain, nausea, and discomfort remain unclear. The aim of the study was to evaluate whether NGT placement is associated with a reduction in pain, nausea, and discomfort scores in patients presenting to the emergency department (ED) with SBO.
Methods
This prospective, multicenter observational cohort study was conducted across eight Swedish EDs between 2024 and 2025. Adult patients with imaging-confirmed SBO were enrolled and NGT placement was based on local practice. The primary outcome was reduction in pain (ΔPain), and secondary outcomes were reduction in nausea (ΔNausea) and discomfort (ΔDiscomfort) on an 11-point numerical rating scale (NRS; 0–10) at inclusion and at ED discharge. Clinically meaningful improvement was defined as a ≥2-point reduction in NRS score. Generalized linear models were used to adjust for baseline symptom severity and administered symptom-altering medications.
Results
Of 226 included patients, 142 (63%) received an NGT and 84 (37%) did not. Baseline demographic and clinical characteristics were similar between groups. Median symptom improvement from inclusion to ED discharge was comparable regardless of NGT use (ΔPain −2, ΔNausea −1, Δdiscomfort −1 in both groups; all P > 0.4) and unchanged after adjustment for baseline symptom severity and medications administered. Half of the patients had clinically meaningful improvement, with no between-group differences (53% versus 52%).
Discussion
NGT placement was not associated with greater relief of pain, nausea, or discomfort in patients with confirmed SBO in the ED.