Nasogastric Ryles Tube: Silicon vs Plastic

There are 2 types of materials used in nasogastric feeding tube: plastic and silicon. There is a substantial difference in the pricing of the ryles tube due to the quality of the materials that are being used.

In Thailand, a plastic ryles tube cost between 12 to 15 baht each and has to be changed on monthly basis. A silicon tube cost between 360 baht to 450 baht each and has to be changed once every 3 months.

My mom has been fitted with both types of feeding tubes. Initially the placement was done in the hospital and a plastic tube was being used. After about 3 more changes of the plastic tube, I tried out the silicon tube and have been using it ever since.

Advantages of a silicon ryles tube:

  • softer and more pliable, more comfortable for the person. My mom rubbed her nose much more less when a silicon tube is being used
  • less phlegm and mucus production as it does not irritate the passageway as a plastic tube does
  • requires change once every 3 months
  • even though it was pliable, it does not break easily. After 3 months when the nurse helped to remove it, it was still intact.

The disadvantages:

  • the tube is more easier to slip out, hence need to be properly secured using the tapes. This is especially so as with Alzheimer’s persons, they always love to rub against the tube with their mittened hands
  • more expensive than a plastic tube (in Thailand, it is 360 baht vs 12 baht)

Do note that when the decision is made to place a person with dementia/Alzheimer’s on a nasogastric feeding tube, their hands would need to be covered with hand mittens to prevent their fingers from pulling out the tube.

Why I stop using a plastic ryles nasogastric tube:

The plastic tube is hard and causes more trauma/irritation for my mom. With Alzheimer’s, my mom loses the ability to express herself. I have to gauge her feelings and situations through observing her actions. When she had the plastic nasogastric tube on, she was rubbing at it constantly as it seemed uncomfortable. There was also more mucus being produced due to the irritation in her nasal and throat passageway.

We are required to change the plastic tube once every 30 days. When the nurse came over to do the change, each time the end of the tube that connects to the stomach is all black in colour and very hard.

The nurse told me it is due to the reaction between her stomach acid with the plastic tube. There was one month where the tube partially broke. I can imagine with any wrong movement, the tube would tug at her linings like a hardened stick. Especially at the part which it has partially broken off, there is a small edge that would hurt the linings. No wonder my mom used to touch the area near her stomach and told me it is painful.

After that incident, we decided to switch to a silicon tube. There would still be mucus and phlegm section due to the irritation with the tube rubbing against the lining of their nasal and digestive track as well as from the dysphagia, which is their decreasing ability to swallow their own saliva, phlegm and mucus.

You can view the YouTube video I made pertaining this in my channel:

 

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