How do people with ALS eat if they can't swallow?

Written by Liu Hong Mei
Neurology
Updated on September 19, 2024
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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.

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Written by Zhang Hui
Neurology
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Early symptoms of amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) refers to motor neuron disease, with patients initially showing mainly reduced hand strength and clumsy fine motor activities, such as difficulty and lack of agility when using a screwdriver. There may also be atrophy of small muscles, such as the interosseous muscles of the hand and the hypothenar muscles, which are commonly seen in clinical settings. Some patients may initially exhibit symptoms like unclear speech, articulation disorders, and coughing or choking while drinking, which are important to recognize. As the disease progresses, the patient's generalized weakness becomes more apparent, with noticeable fasciculations and significant muscle atrophy developing clinically.

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Written by Liu Hong Mei
Neurology
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How to exercise for swallowing difficulties in people with amyotrophic lateral sclerosis

Swallowing difficulties in amyotrophic lateral sclerosis primarily involve exercises for oral muscles. Improvement in the movement of oral muscles can alleviate symptoms of swallowing difficulties. Rehabilitation training for oral muscle disorders mainly includes enhancing the movements of the lips, tongue, and lower jaw. Individuals with amyotrophic lateral sclerosis who have brainstem damage and medullary damage may experience swallowing difficulties, water drinking issues, and cough choking, primarily due to sensory disturbances in the throat. By utilizing temperature and sensory stimulation, the sensation in the patient's throat can be restored, allowing them to perceive the temperature and taste of food, thus reducing aspiration. After brainstem damage, the cricopharyngeal muscle does not open, which can be improved through balloon dilation and medication to enhance swallowing function.

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Written by Zhang Hui
Neurology
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Can amyotrophic lateral sclerosis be relieved?

Amyotrophic lateral sclerosis (ALS) refers to a motor neuron disease, and generally speaking, there are no effective alleviation measures for this disease. Currently, the specific causes and pathogenesis of this disease are not very clear. Various factors lead to the simultaneous damage of both upper and lower motor neurons in patients. Clinical manifestations include muscle weakness, muscle atrophy, and fasciculations. Additionally, patients may experience difficulties with swallowing, choking while drinking water, and speech disorders. In its most severe form, it can affect breathing, leading to respiratory failure. This disease progressively worsens, and the prognosis is generally poor with no effective relief methods available.

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Written by Liu Shi Xiang
Neurology
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Does amyotrophic lateral sclerosis skip generations in inheritance?

Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, may possibly be inherited through generations. The exact cause of ALS is still not very clear, but there is a certain genetic predisposition. Patients with ALS gradually experience symptoms such as limb weakness and muscle atrophy. As the disease progresses, it will eventually lead to difficulties in speech, swallowing disorders, and breathing difficulties, resulting in the patient losing the ability to take care of themselves independently and requiring full-time care from others. Currently, ALS is an incurable disease. The treatment available to patients includes medications to nourish the nerves and systematic rehabilitation training. However, this treatment can only improve the symptoms to a certain extent and enhance the quality of life but cannot stop the progression of the disease. Eventually, the patient will be confined to bed.

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Written by Li Qiang
Intensive Care Unit
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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.