When can I disconnect the NG tube?
Criteria for readiness before removing a nasogastric feeding tube.
The feeding tube serves as a temporary bridge and can be removed when it is safe to swallow and sufficient food has been eaten.
Acute phase, depending on the assessment method.
Including pills.
When the team deems it necessary.
Relatives are prohibited from removing or putting on the item themselves.
Many relatives have been asking if my parents, who have been using nasogastric feeding tubes for a long time, can have them removed yet.The answer depends on how safe it is to swallow and whether enough has been ingested orally, not on how many days it has been worn.
This article is not a guide for removing feeding tubes. Removing or inserting feeding tubes is the responsibility of the medical team only.
The content in this article
1. When can the NG tube be removed? Why is there no fixed number of days?
Short answer:The device can be removed once the medical team assesses that the patient can safely swallow it and is able to consume food, water, and medication orally. For some, it takes a few weeks; for others, it can take several months, so there's no single timeframe that applies to everyone.
The European guidelines ESO/ESSD (2021) state that patients with acute stroke...Difficulty swallowing is experienced by approximately 29–81%.Depending on the assessment method, swallowing ability must be screened before administering food, water, or medication orally. Retrospective research from Taiwan (Chuang et al., 2023) followed 63 stroke patients and found that 65% were able to have the feeding tube removed before discharge. Those who could perform more daily activities and had a higher level of oral intake had a greater chance of having the tube removed. The limitation is that this was a small-scale study and not KIN data.
Even while wearing a feeding tube, you can practice swallowing.The German Society for Clinical Nutrition (DGEM 2013) guidelines state that nasogastric feeding does not interfere with swallowing training and should be started early.Rehabilitation of patients with swallowing difficulties.
The team considers many factors, not just the number of days.
2. What factors does the medical team consider before removing the feeding tube?
Short answer:The team considers alertness, posture, saliva management, swallowing assessments, actual food intake, and general symptoms, all assessed on an individual basis, not as a fixed list used for everyone.
- I'm awake and fully aware.They can follow simple instructions. Those who remain lethargic often require tube feeding (DGEM).
- I can sit upright.Staying stable both during and after eating (ASHA)
- It can manage saliva.The patient can swallow on their own, and there is no phlegm buildup that requires frequent suctioning.
- Passed the swallowing assessment.Bedside assistance and VFSS or FEES when the team deems necessary (ESO/ESSD).
- It can be eaten orally.The team monitored the amount of food, water, and medication.
- Common symptomsStable comorbidities; the team uses this information in conjunction with swallowing assessment results, not as a substitute for it.
DGEM states that the patient was conscious and still using most of the catheters.It should be administered orally as a supplement. Only the food itself and the quantity that the team has assessed as safe to swallow.Relatives are prohibited from attempting to feed the animal themselves using ESO/ESSD. Monitor food and water intake carefully, as thickened foods may result in insufficient hydration. Do not adjust the consistency yourself. Read the instructions.Viscosity enhancing powder and IDDSI level.
3. Assess swallowing using three methods: bedside VFSS and FEES. What are the differences between them?
Short answer:At the bedside, the assessor visually and manually observes the swallowing process. VFSS is a visual examination during swallowing (VFSS). FEES is an endoscopic examination of the throat during swallowing (FEES). Not everyone needs all of these tests; the team selects them based on risk.
| way | how | What it tells you / Limitations |
|---|---|---|
| Beside the bed | Observe their alertness, posture, mouth, tongue, and saliva, then try swallowing a small amount. | Used for screening, but it's invisible in the throat and may miss silent aspiration. |
| VFSS | Swallowing food mixed with contrast agent in front of an X-ray machine. | If you see the mouth, pharynx, and upper esophagus, you need to go to the X-ray room. |
| FEES | A small endoscope is inserted through the nose to view the throat while the person swallows. | Observe food particles remaining and choking; do this bedside. |
Source: ASHA Adult Dysphagia · ESO/ESSD 2021
ESO/ESSD recommends detailed evaluation in unscreened or at-risk individuals, such as those with severe facial paralysis or severe speech impairment. Retrospective research from Korea (Hwang et al., 2017) used VFSS results to decide on catheter removal in 199 patients and suggested early testing to avoid unnecessary catheterization.
Bedside assessment is the first step.
4. Who decides to remove the feeding tube, and who removes it?
Short answer:The doctor, in consultation with the swallowing assessment team, nurses, and family, makes the decision. Removing or inserting the tube is the responsibility of healthcare personnel as instructed by the doctor. Relatives should not remove or insert the tube themselves, even if the patient requests it.
ASHA explained that the decision regarding the endotracheal tube is made in collaboration with the medical team, and the family also plays a part in the decision. The team should be asked:What issue are we still stuck on, and when will we reassess?For home-patients, changing or inserting the NG tube is the responsibility of...Registered nurses who visit homes.
If the cable is loose or shifted, do not attempt to handle it yourself. Do not push it back, do not reinsert it, and do not switch to oral feeding instead.Stop feeding, position the head elevated, and immediately notify the nurse if you experience difficulty breathing or turn blue. Call 1669.
"The feeding tube is a temporary bridge. It can be removed when the baby can safely swallow and has eaten enough, not after a full day."
5. What is silent choking? Signs that relatives should watch for after starting to eat orally.
Short answer:Silent aspiration is when food or water enters the trachea without visible coughing. Family members should look for other signs such as a wet sound after swallowing, fever, rapid breathing, increased sputum, lethargy, or decreased appetite, and notify the medical team.
ASHA describes coughing as...It's not always related to choking.A review by Ocrospoma and Restrepo (2024) indicates that elderly patients with pneumonia may not have a fever or a noticeable cough.
Call 1669 immediately.
• Choking and difficulty breathing; coughing without sound; lips or face begin to turn blue.
• Breathing heavily, lethargic and unresponsive to being woken up.
- Notify the team within the day.Wet throat sound after swallowing, coughing while eating, reduced food intake.
- See a doctor.Fever, increased phlegm, rapid breathing. (Read)Aspiration pneumonia
Silent choking requires observation of several factors.
6. If you can't swallow for several weeks, what is PEG and when should it be replaced?
Short answer:PEG (Peritoneal Erystomy Tube) is a feeding tube inserted through the abdominal wall into the stomach. Some guidelines recommend considering it when tube feeding is expected to last longer than 28 days. This is a decision made by a doctor in consultation with the family, and it doesn't mean that oral feeding can't be resumed.
DGEM recommends using a nasogastric tube initially. If a longer than 28-day stay is anticipated, opt for a PEG during the stable phase (approximately 14–28 days). If swallowing difficulties persist after discharge, a reassessment by the healthcare team is necessary, based on individual symptoms and follow-up plans. Swallowing exercises can continue even with PEG insertion. This is general information, not individualized recommendations.
How does KIN help patients who are still using feeding tubes and their families?
KIN Ladprao 71Located in Soi Nak Niwas 18 is an inpatient rehabilitation center that provides personalized swallowing assessment and training plans, along with other rehabilitation activities. Results vary from person to person, and the decision to remove the feeding tube remains with the physician.
- Swallowing exercises performed by a speech therapist.And there are tools for occupational therapy.
- Stroke rehabilitation programThere are occupational therapy, speech therapy, and swallowing therapy programs, all tailored to each individual.
- The doctor visits every Sunday.Rehabilitation physician and geriatric physician.
- We provide care for patients who are fed through a nasogastric tube and abdominal tube.According to the center's acceptance criteria.
- Inquire about our services and visit the site for free any day.9:00 AM – 6:00 PM (excluding medical examinations)
Contact KIN Ladprao 71 | Free consultation and visit.
Patients with feeding tubes who require swallowing exercises and speech therapy can consult with the team daily.
Other branches of KIN Rehabilitation
KIN Salaya
Buddhamonthon · Opening December 15, 2026 · Advance reservations are now available.
Central hotline:02-096-4996| Home-based physiotherapy 095-767-6307 | Care, nursing, and equipment rental 061-881-9399 | Emergency call 1669
Frequently Asked Questions answered by the KIN medical and multidisciplinary team.
When can I disconnect the NG tube?
There is no fixed number of days. The team will remove the tubes when the patient is alert, can sit upright, can swallow, passes the swallowing assessment, and can adequately consume food, water, and medication orally.
Can relatives remove the nasogastric feeding tube themselves at home?
No, you should not. If the feeding tube comes loose on its own, even after just feeding, do not reinsert it and do not feed orally instead. Stop feeding, position the patient with their head elevated, and notify a nurse immediately. If the coughing doesn't stop or they have difficulty breathing, call 1669.
Do all people need to take FEES or VFSS tests?
Not everyone. The guideline is to screen everyone first, and then conduct more thorough testing on those who fail the screening or are at high risk.
If I cough or have a wet voice after eating, does that mean I'm still choking?
This is a signal that needs to be reported to the team. However, some people may choke without coughing, so you need to monitor for fever, rapid breathing, and phlegm. If the person is choking to the point of difficulty breathing, call 1669 immediately.
After disconnecting the NG tube, what should I observe next?
Monitor food and water intake, urine output, weight, and signs of aspiration such as fever, wet voice, and rapid breathing. If food intake decreases or aspiration occurs frequently, notify the reassessment team, as some cases may require tube feeding again.
When do I need to switch to a peritoneal catheter (PEG)?
Some guidelines suggest considering tube feeding for longer than 28 days. This is a decision made by the doctor in consultation with the family, and swallowing exercises can continue.
- European Stroke Organization and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia — Dziewas R et al. European Stroke Journal 2021
- Guideline clinical nutrition in patients with stroke — Wirth R et al. (DGEM) Exp Transl Stroke Med 2013.
- Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients — Chuang ST et al. Medicina, 2023.
- Recommendation of Nasogastric Tube Removal in Acute Stroke Patients Based on Videofluoroscopic Swallow Study — Hwang JM et al. Ann Rehabil Med 2017
- Severe aspiration pneumonia in the elderly — Ocrospoma S, Restrepo MI J Intensive Med 2024
- Adult Dysphagia — ASHA Practice Portal
Medical accuracy verified by Dr. Thanyachanok Chuthamasathit, License No. 62998, Medical Director of Rehabilitation Medicine | Supervised by Dr. Thongchai Chokthanomsap, Chairman of the Executive Board | Last updated: October 2026 |This article provides preliminary information and is not a specific medical diagnosis or advice. Removal or insertion of feeding tubes must be decided and performed by the medical team. Research figures do not represent the results of patients using KIN services.