In a patient with suspected toxic megacolon, what is the purpose of inserting a nasogastric tube?

• A. To provide nutrition
• B. To decompress the stomach
• C. To remove bile
• D. To measure gastric pH

Answer: (B)

In suspected toxic megacolon, the goal is to relieve the dilated bowel and prevent complications from overstretched, inflamed colon. Placing a nasogastric tube achieves this by decompressing the stomach and proximal gut—suctions out air and gastric contents, lowers intraluminal pressure, and helps reduce vomiting and the risk of aspiration. This decompressing effect is essential while the patient is being stabilized with fluids, electrolytes, antibiotics, and other supportive measures. Feeding through the tube is usually avoided in this acute setting because enteral nutrition can worsen distension; if nutrition is needed later, it’s typically started after stabilization. The tube isn’t used to remove bile or to measure gastric pH as a primary purpose.