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A frequent mechanical problem encountered with small-bore feeding tubes is lumenal obstruction of the tube. A number of studies have described methods to prevent tube occlusion and restore patency once the tube becomes occluded. It has been observed that most intact protein formulas will clot when acidified to a pH of less than 5.0. This study evaluated the question of whether gastric feeding tubes occlude more frequently when they are used for checking gastric residuals by aspirating acidic gastric juices into the tube than when gastric residuals are not checked. Patients who were fed intragastrically via a small-bore feeding tube with intact protein formulas were divided into two groups. Gastric residuals were checked in group A patients every 4 hours, whereas no residuals were checked in group B patients. Fifteen patients in group A were followed for a total of 138 patient days and 13 patients in group B were followed for 154 patient days. Ten occlusive episodes occurred in the group A patients, whereas only one occlusive episode occurred in the group B patients. This difference was statistically significant (p = .0171). We concluded that small-bore feeding tubes occlude more frequently when used to aspirate gastric residuals.