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 Zhang Hui

Neurology

45sec

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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

59sec

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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.

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Written by Liu Shi Xiang

Neurology

1min 17sec

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Does amyotrophic lateral sclerosis cause leg soreness?

Patients with amyotrophic lateral sclerosis (ALS) may experience leg pain, but leg pain is not the primary clinical manifestation of ALS. The early main symptoms of ALS include muscle atrophy and limb weakness. As the disease progresses, patients will further experience general muscle atrophy and weakness, which may manifest as difficulty in swallowing, speech problems, and respiratory difficulties. As the disease progresses, if the patient experiences extreme muscle atrophy and limb weakness, they may experience leg pain during movement, but this symptom is not specific. Therefore, when symptoms such as muscle atrophy and limb weakness occur, the possibility of ALS should be considered, and patients need to undergo timely examinations such as electromyography and muscle biopsy to confirm the diagnosis. If the patient also suffers from leg pain, other conditions such as sciatica and osteoporosis should be considered, and further examinations like bone density tests and lumbar disc magnetic resonance imaging should be conducted to clarify the diagnosis.

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Written by Liu Hong Mei

Neurology

54sec

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Is amyotrophic lateral sclerosis (ALS) contagious?

Amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease, is not contagious. It is a genetic disease associated with autosomal dominant inheritance and is not considered an infectious disease. The exact cause of ALS is still unclear. Commonly identified mechanisms include genetic factors, inflammatory agents, excitotoxic effects from amino acids, infections, autoimmune factors, exposure to toxins, and heavy metal poisoning from metals like lead, mercury, and aluminum. Other contributing factors may include a deficiency in nerve growth factors, mitochondrial dysfunction, and apoptosis. These factors may likely be involved in the development of ALS symptoms, but the disease is not communicable.

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Written by Li Qiang

Intensive Care Unit

52sec

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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.