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May 8, 2026European Stroke Journal0 citationsOpen Access

Abstract Number: Esoc2026a1063 Oranges and Lemons

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HMHolly MaguireUniversity Hospitals of North Midlands NHS TrustSSSurabhi SaxenaUniversity Hospitals of North Midlands NHS TrustGCGrace CasquejoUniversity Hospitals of North Midlands NHS Trust

Key Points

  • The aim is to explore the effectiveness of orange or lemon juice in stimulating gastric fluid production for nasogastric tube position checks in stroke patients.
  • Applied gauze soaked in orange or lemon juice to patients' gums and tongue after unobtainable gastric aspirate.
  • Attempted gastric fluid aspiration again after juice application in 30 stroke patients requiring position check.
  • Gastric fluid was successfully aspirated in all 30 stroke patients following orange or lemon juice application.
  • Chest x-ray was not required for any of these patients after the juice application.

Abstract

Abstract Background and aims Dysphagia is common following stroke affecting up to 60% of patients, with around half of this group requiring a nasogastric tube (NGT) for nutrition, hydration, and medication administration. After the placement of and prior to any use of an NGT its position must be checked to ensure its sitting within the stomach. The first line check involves aspiration of gastric fluid, pH of this fluid is assessed with a level of less than 5.5 indicating acidity and that the NGT is sitting within the stomach and safe to use, but often an aspirate is unobtainable. When this occurs the standard investigational method of checking NGT position is a chest x-ray, but the process of obtaining a chest x-ray can take many hours and occur daily. Methods After an unobtainable gastric aspirate, gauze soaked in orange or lemon juice is wiped along the patients’ gums and tongue. Within minutes of this procedure a second attempt to aspirate gastric fluid is made with great success. Results Data was collected following the use of orange or lemon juice to stimulate gastric fluid production in 30 stroke patients requiring NGT position check. Gastric fluid was successfully aspirated in all of these patients following orange or lemon juice and chest x-ray was not then required. Conclusions Orange or lemon juice applied to the gums appears to stimulate gastric fluid production and warrants further investigation as has the potential to decrease the need for chest x-rays and reduce the time patients are left without nutrition, hydration and medications. Conflict of interest Holly Maguire nothing to disclose, Grace Casquejo nothing to disclose, Surabhi Saxena nothing to disclose

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Cite This Study

Maguire et al. (2026) studied this question.

synapsesocial.com/papers/69fd7f4fbfa21ec5bbf07cb9https://doi.org/10.1093/esj/aakag023.1481
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