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Ryles Tube Feeding at Home: A Safe Guide for Families

When a loved one comes home from hospital with a thin tube in the nose, many families feel nervous. This tube is a nasogastric (NG) tube, which is often called a Ryles tube in India. It goes in through the nose, down the food pipe and into the stomach. Liquid feed, water and medicines can be given through it when the person cannot eat or drink safely, or cannot take enough by mouth.

With the right training and a few checks every time, families can give Ryles tube feeding at home safely.

Why Doctors Advise a Ryles Tube

A doctor may advise a Ryles tube when:

• The person has swallowing problems, which can happen after a stroke or with some other conditions of the brain and nerves
• Food or drink may go down the wrong way into the lungs
• The person is very drowsy or unwell, or is not eating enough

A Ryles tube is usually a short-term option. The doctor will review how long it is needed. If feeding is needed for longer, they may discuss a different type of feeding tube placed directly into the stomach.

Training Before You Leave Hospital

Before discharge, ask the nurse to show you each step and watch you practise: checking the tube, feeding, flushing, giving medicines and nose care. Ask for a written plan from the doctor or dietitian with the feed, amounts, timings and water flushes. Note the number or mark on the tube at the nostril, so you can tell if it moves.

Check the Tube Every Time, as You Were Trained

The most serious risk is the tube being out of place, so that feed or medicine goes into the lungs. Coughing, vomiting or a pull on the tube can move it.

Check the position exactly as the nurse or doctor trained you:

• Before every feed, every flush of water and every medicine
• After a bout of coughing, retching or vomiting
• If more tube is showing than usual, or the tape has come loose

The check usually includes looking at the mark at the nostril and, where you have been trained, testing a little fluid drawn back from the tube with a pH strip.

If you are not sure the tube is in the right place, do not put anything down it. No feed, no water, no medicine. Call the nurse or doctor for advice first.

Giving Feeds Safely

Position: sit the person up, or raise the head and upper body to about 30 to 45 degrees, during the feed and for about an hour afterwards, unless the team advises otherwise. For overnight feeds, prop them up with pillows. A hospital bed with a backrest that lifts can make this easier.

The feed: give only the feed the doctor or dietitian has prescribed, in the amount and at the times they have set. Do not add foods, home remedies or other liquids they have not advised, as these can block the tube. Wash your hands and use a clean surface and clean syringes every time.

Flushing: flush the tube with water before and after each feed and each medicine, using the amount and type of water in your plan. Never force it. If the tube seems blocked and gentle flushing as you were taught does not clear it, stop and call the nurse. Never push anything else into the tube to clear it.

Medicines Through the Tube

Give medicines through the tube only as the doctor or pharmacist advises. Some tablets must not be crushed, and some medicines work differently with feeds, so ask first. Give each medicine separately, with a flush of water before, between and after, and do not mix medicines into the feed. Never start, stop or change a medicine on your own.

Nose, Mouth and Tube Care

• Nose and skin: clean the skin around the tube gently with warm water after feeds, as the nurse shows you, and check the nostril every day for redness, soreness or dry, cracked skin.
• Securing: check every day, and before each use, that the tape on the nose or cheek is clean and firmly stuck. Ask the nurse how to change it safely.
• Mouth care: brush the teeth, gums and tongue twice a day, even if the person eats nothing by mouth. Keep the lips moist.
• Eating and drinking: give nothing by mouth unless the doctor or speech therapist has said it is safe.

If the Tube Moves or Comes Out

• If the mark at the nostril has changed, do not use the tube. Call the nurse or doctor.
• If the tube comes out partly or fully, do not push it back in. Only a trained nurse or doctor should place a tube.
• Keep the tube and show it to the nurse or doctor.
• If the person cannot take anything by mouth, the tube will need to be replaced soon, so contact the team without delay.

When to Call the Doctor

Stop the feed and call the nurse or doctor if the person:

• Coughs, chokes or becomes breathless during or after a feed
• Vomits, or has a swollen, bloated tummy
• Has a fever, or redness and swelling in the nostril
• Has a tube that keeps blocking, or blood in the tube
• Has diarrhoea or constipation that does not settle

Do not restart the feed until the tube has been checked.

When to Call 112

Call 112 straight away if the person has severe difficulty breathing (gasping, choking or unable to speak), lips or skin turning blue or grey, chest tightness, or sudden confusion. Read what to do in a medical emergency at home.

How OSVI Healthcare Helps with Ryles Tube Feeding

With nursing care at home from OSVI Healthcare, trained nurses provide Ryles tube feeding care at home, as the treating doctor advises, in hourly visits or 12-hour or 24-hour shifts.

• Doctor visits: a doctor visit at home, day or night, with a prescription and follow-up.
• Equipment: hospital beds with adjustable backrests and air mattresses to rent or buy through medical equipment at home, set up by trained staff.
• Medicines: medicines can be delivered at home.
• One point of contact: a care manager coordinates the care, and the care plan is supervised by a qualified doctor. Our care team is available 24×7.

Frequently Asked Questions

Can a person with a Ryles tube eat or drink by mouth?

Only if the doctor or speech therapist has checked their swallowing and said it is safe. If swallowing is not safe, food or drink can go into the lungs.

How long can a Ryles tube stay in?

It is usually meant for short-term feeding. The doctor will review how long it is needed, when it should be changed, and whether another type of feeding tube would be better.

Can we put the Ryles tube back in ourselves if it comes out?

No. Do not push it back in. Call the nurse or doctor, as the tube must be placed and checked by a trained professional.

This article is provided for general information and does not constitute medical advice, diagnosis or treatment. Every patient’s situation is different, so please consult a qualified doctor for guidance specific to you. In a medical emergency, call 112.