What should people with ALS do if they cannot eat?

Written by Liu Hong Mei
Neurology
Updated on September 04, 2024
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People with amyotrophic lateral sclerosis who are unable to eat may try liquid and semi-liquid diets, using warm liquids, eating little by little. If they cannot consume a liquid diet, they may need to resort to nasogastric feeding. A gastric tube is used for feeding, through which high-nutrition, high-protein, and high-calorie diets can be provided to sustain and extend the life of those with the condition. Avoid overeating and engage in appropriate exercise, paying attention to the functions of the respiratory and digestive systems. If there is excessive saliva, a small amount of antihistamine medication can be administered. If there is an excess of phlegm, nebulized inhalation and expectorant medications might be provided. If feeding through a gastric tube is also limited, intravenous nutritional support can be given.

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Written by Liu Hong Mei
Neurology
1min 10sec home-news-image

Is it normal for someone with ALS to have severe swelling in their feet?

ALS patients with severe foot swelling is not normal. If an ALS patient experiences severe swelling of the feet, it is important to be cautious of the formation of blood clots in the lower limb vessels. The formation of venous blood clots can lead to poor blood circulation, easily causing blood stasis and thrombotic obstruction, leading to severe swelling of the feet. It is necessary to conduct a Doppler ultrasound of the lower limb vessels to assess their condition. Treatments may include anti-platelet aggregation, anticoagulation, promoting blood circulation to remove blood stasis, and providing nutritional support to nerves. Heat application, keeping warm, promoting lower limb blood circulation, acupuncture, physical therapy, massage, and heat application can be used as symptomatic treatments. For ALS patients with severe foot swelling, it is advisable to elevate the lower limbs during sleep, perhaps covering them with a blanket or elevating them about 45 degrees.

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Written by Liu Hong Mei
Neurology
54sec home-news-image

Do people with early ALS have leg pain?

Early-stage ALS (Amyotrophic Lateral Sclerosis) patients often experience leg pain symptoms. ALS is generally caused by factors such as inflammatory reactions, genetic factors, neuronal apoptosis, infection, autoimmunity, and metal poisoning. These factors may lead to the degenerative death of nerve cells, causing muscle atrophy, muscle weakness, fasciculations, increased muscle tone, hyperactive tendon reflexes, and symptoms of muscle fatigue, muscle tension, and muscle pain. In the early stages of ALS, muscle fatigue can occur after activity due to lactic acid not being properly expelled, leading to muscle pain. Treatments such as acupuncture, physiotherapy, and massage can be administered to alleviate these symptoms.

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Written by Liu Hong Mei
Neurology
1min 1sec home-news-image

What should people with ALS do if they cannot eat?

People with amyotrophic lateral sclerosis who are unable to eat may try liquid and semi-liquid diets, using warm liquids, eating little by little. If they cannot consume a liquid diet, they may need to resort to nasogastric feeding. A gastric tube is used for feeding, through which high-nutrition, high-protein, and high-calorie diets can be provided to sustain and extend the life of those with the condition. Avoid overeating and engage in appropriate exercise, paying attention to the functions of the respiratory and digestive systems. If there is excessive saliva, a small amount of antihistamine medication can be administered. If there is an excess of phlegm, nebulized inhalation and expectorant medications might be provided. If feeding through a gastric tube is also limited, intravenous nutritional support can be given.

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Written by Li Qiang
Intensive Care Unit
52sec home-news-image

Is it necessary to perform a tracheotomy in the late stages of ALS?

Patients in the late stages of amyotrophic lateral sclerosis (ALS) must undergo a tracheotomy because, by this stage, they have completely lost their motor abilities, including the muscle strength needed for breathing. Consequently, they lack the strength to breathe on their own, leaving them unable to survive without a ventilator. They must rely continuously on a ventilator to breathe as they cannot do it themselves. Therefore, if a ventilator is needed over the long term, a tracheotomy is necessary. This is because other methods, such as inserting tubes through the mouth or nose into the trachea to connect to the ventilator, are quite uncomfortable. Comparatively, tracheotomy offers a bit more comfort, making it a necessary procedure for connecting to a ventilator for long-term use and achieving greater comfort.

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Written by Liu Hong Mei
Neurology
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How do people with ALS eat if they can't swallow?

Patients with amyotrophic lateral sclerosis (ALS) who no longer have swallowing function can be given nasogastric feeding and intravenous hyperalimentation to maintain nutrition and electrolyte balance. For patients with respiratory difficulties or respiratory failure, oxygen supplementation can be administered. This can be combined with treatments such as acupuncture, physical therapy, massage, and heat application. It is important to prevent complications such as pulmonary infections, aspiration pneumonia, hypostatic pneumonia, lower extremity venous thrombosis, acute gastritis, gastric mucosal erosion, and gastrointestinal bleeding, which are common in later stages of ALS. With the loss of swallowing function and decreased immunity, these complications can occur more frequently and require proactive treatment to improve nutritional status.