Dark Green Fluid in Nasogastric Tube: Causes and Concerns

The nasogastric tube contains dark green fluid?

Hello Dr.
Chen: My father has been bedridden for over six months and is currently being fed liquid milk through a nasogastric tube.
Recently, he has been coughing, and deep green liquid has been coming out of the nasogastric tube.
Is this a sign of indigestion? What is this deep green liquid? Is there an issue with his digestive system? This is the first time this has happened in the past six months.
My father has a history of diabetes and is currently on insulin for control.
Due to a fall resulting in a brain injury, he is unable to speak and cannot communicate where he feels discomfort.
Thank you for your response, doctor.
Thank you.

Xia Tian, 40~49 year old female. Ask Date: 2016/12/21

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, sir.
It is likely that bile has refluxed into the stomach and caused vomiting, which is why it appears yellow-green.
Antiemetic and prokinetic medications may be added.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2016/12/21

More Info

The presence of dark green fluid in a nasogastric (NG) tube can be concerning, especially in a patient who has been bedridden for an extended period and has underlying health conditions such as diabetes. Understanding the potential causes and implications of this observation is crucial for managing the patient's health effectively.

Firstly, the dark green color of the fluid can be attributed to several factors. One common reason is the presence of bile, which is produced by the liver and stored in the gallbladder. Bile is typically greenish due to the pigment biliverdin, which is a breakdown product of hemoglobin. When a patient is not eating solid food and is instead receiving nutrition through an NG tube, the digestive system may not be functioning in the usual way. If the stomach is empty or if there is a delay in gastric emptying, bile can accumulate and may be expelled through the NG tube, resulting in dark green fluid.

Another possibility is that the dark green fluid could be related to the breakdown of certain foods or medications. If the patient has been receiving any liquid nutritional supplements or medications that contain iron or other pigments, these could also contribute to the coloration of the fluid. Additionally, if there has been any gastrointestinal bleeding, the blood can also appear dark green or black as it is digested and mixed with bile.

Given that your father has been bedridden and has a history of diabetes, it is essential to consider the overall health status and any potential complications. Bedridden patients are at risk for various issues, including aspiration pneumonia, constipation, and gastrointestinal motility disorders. The presence of dark green fluid could indicate a change in gastrointestinal function, which may warrant further investigation.

It is advisable to consult with a healthcare professional, particularly a gastroenterologist, to evaluate the situation. They may recommend performing a physical examination and possibly conducting tests such as imaging studies or laboratory tests to assess for any underlying issues. Monitoring for other symptoms, such as abdominal pain, changes in bowel habits, or signs of infection, is also important.

In summary, while the presence of dark green fluid in the NG tube may not immediately indicate a severe problem, it is essential to investigate the cause further, especially in a patient with complex medical needs. Regular communication with healthcare providers and close monitoring of the patient's condition will help ensure that any potential issues are addressed promptly.

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