Written and maintained by CASRAI Editorial Board
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This page describes products and general use; it is not medical advice.
Irrigating a nasogastric (NG) tube means passing water through the tube with a syringe to keep it clear. Clinic staff, buyers and students searching for it mostly want to know which syringe and connector are involved and why connector standards matter. This page covers the equipment and published safety guidance. It does not give instructions for treating an individual patient.
What irrigating an NG tube means
In everyday use, “irrigating” and “flushing” a nasogastric tube both describe passing water through the tube. One NHS trust’s home enteral feeding pack (The Christie NHS Foundation Trust, June 2017) lists three purposes for flushing: to prevent blockages, to check that the tube is not blocked before it is used, and to give extra water during the day. Individual plans differ, and local practice may vary. For the tube itself, see what a nasogastric tube is and NG tube sizes for adults.
Who uses it: nurses and other clinicians, and carers or patients who have been trained for home enteral feeding by their clinical team.
Equipment used
Syringe
The Christie pack specifies a purple oral/enteral 60 ml syringe. It describes separate arrangements for hospital and home syringes, including cleaning and replacement of home syringes; those details belong to the trust’s own pack and the patient’s clinical team. See what a syringe is for syringe types in general.
Water
The Christie pack names cooled boiled water as the fluid for its flushing, unless a clinical team has directed otherwise. Fluid choice is a clinical decision for each patient.
Connector
The syringe has to fit the tube’s connector, which is why connector standards matter. The next section explains the FDA’s position.
Why connectors matter: ENFit and ISO 80369-3
In a letter dated 7 September 2018, the US FDA recommended that hospitals and clinicians use enteral devices with connectors that meet the ISO 80369-1 or ISO 80369-3 standard, many of which are identified by the trade name ENFit. The letter says misconnections between enteral devices and other medical devices, such as tracheostomy tubes, have been associated with patient death and serious injuries, and that since 2011 the FDA had received reports of 2 deaths, 24 serious injuries and 32 device malfunctions related to enteral misconnections. It also noted that ISO 80369-3 connectors have slightly narrower openings than some connectors on the market, and that FDA testing of commercial formula and blenderized diets found flow rates may be slightly slower, which the FDA said does not pose a safety concern.
| FDA advice in the 2018 letter | Audience |
|---|---|
| Check the labeling or check with the distributor or manufacturer whether connectors meet the ISO standards | Health care professionals |
| Do not modify or adapt devices, since that may defeat their safety system | Health care professionals |
| Minimize the use of transition adapters | Health care professionals |
| Do not use cross-application connectors | Health care professionals |
| Trace all lines back to their origin when reconnecting devices | Health care professionals |
| Purchase enteral devices that comply with the ISO 80369-1 or ISO 80369-3 series standards | Hospital purchasing departments and distributors |
The letter also refers to the FDA’s 2015 guidance, “Safety Considerations to Mitigate the Risks of Misconnections with Small-bore Connectors Intended for Enteral Applications”. Related equipment is covered in what a feeding tube is and feeding tube bags.
Common mistakes
- Using a syringe or adapter that does not match the connector standard, or modifying devices to make them fit (FDA, 2018).
- Relying on transition adapters or cross-application connectors where a compliant device is available (FDA, 2018).
- Reconnecting lines without tracing them back to their origin (FDA, 2018).
FAQ
Is nasogastric tube irrigation the same as flushing?
In common use, yes. Both refer to passing water through the tube.
Why do people flush an NG tube?
One NHS trust’s pack gives three purposes: preventing blockages, checking that the tube is not blocked before use, and giving extra water during the day.
Why does the syringe connector matter?
The FDA reports deaths, injuries and malfunctions linked to enteral misconnections and recommends devices meeting ISO 80369-3 (ENFit).
Where can I find the right method for a particular patient?
From the patient’s own clinical team. This page covers equipment and published safety guidance only.
Sources
- US FDA, CDRH, “The FDA Encourages Use of Enteral Device Connectors that Reduce Risk of Misconnection and Patient Injury”, 7 September 2018: https://www.fda.gov/downloads/MedicalDevices/ResourcesforYou/Industry/UCM619782.pdf (checked 2026-10-30).
- The Christie NHS Foundation Trust, “Home Enteral Feeding Information Pack: How to care for your nasogastric tube”, June 2017 (CHR/NUT/966): https://www.christie.nhs.uk/media/jcpcldxe/966-hef-nasogastric-tube-pack-june-2017.pdf (checked 2026-10-30).
