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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Supine numb up nose with syringe and swab and throat with spray
Place tube through right nostril into stomach without guide wire
Distend stomach if needed with 100 cc of air
Place guide wire through tube
Deep breaths to help tube advance
RPO and advance tube to antrum
LPO and advance tube through pylorus to duodenal bulb
Supine to put tube through the C-loop
RPO for passing the Ligament of Treitz
Tape tube to nose
Single contrast - flow rate of 160-220 ml/min for barium
Double contrast - flow rate of 120 ml/min for barium and 90-100 ml/min for Methylcellulose
Run barium until you hit distal jejunum and then turn on methylcellulose
Take lots of spot films
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