CC BY 4.0 · Avicenna J Med 2023; 13(04): 193-198
DOI: 10.1055/s-0043-1776338
Review Article

Nasoenteric Tube Placement in Patients with Esophageal Varices: A Review of the Current Evidence and Society Guidelines

Osama Qasim Agha
1   Department of Internal Medicine, Creighton University School of Medicine, Phoenix, Arizona, United States
2   Department of Internal Medicine, St Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
3   Department of Internal Medicine, University of Arizona College of Medicine, Phoenix, Arizona, United States
Muhammad Alsayid
4   Division of Digestive Diseases, Rush University Medical Center, Chicago, Illinois, United States
Justin Reynolds
1   Department of Internal Medicine, Creighton University School of Medicine, Phoenix, Arizona, United States
5   Center for Liver and Hepatobiliary Disease, St Joseph's Hospital and Medical Center, Phoenix, Arizona, United States
› Author Affiliations
Funding No funding was obtained for this study.


Esophageal varices are a common complication of portal hypertension and variceal bleeding can be associated with significant morbidity and mortality. Hospitalized patients with cirrhosis might require nasoenteric tube (NET) placement, commonly for nutritional support and/or medication administration. However, the fear of causing massive variceal bleeding among clinicians might lead to hesitancy or complete avoidance of NET placement in patients who either have a known history of esophageal varices or are at risk to have them. Several experts and society guidelines addressed this concern with variable recommendations and degrees of evidence. In this article, we present an extensive review of the literature and latest society guidelines that address the safety of NET placement in patients with esophageal varices.

Authors' Contributions

O.Q.A. designed and wrote the initial draft of the manuscript. M.A. and J.R. reviewed, edited, and substantially contributed to the initial version of the manuscript. All authors reviewed, edited, and substantially contributed to the final version of the manuscript. All authors agree to be accountable for all aspects of the work.

Publication History

Article published online:
01 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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