ALS Nutrition and Feeding
As the muscles that control chewing and swallowing weaken, eating and drinking become more difficult, until they’re impossible to manage safely. At first, foods with a softer consistency can still be swallowed safely. Some people with ALS find that blenderized foods can be sucked through a large, sturdy straw more easily than spooned up, probably because the muscles that move food from the front to the back of the mouth aren’t as necessary with this technique. As throat muscles weaken, the possibility of choking on food or “swallowing the wrong way” increases markedly and poses a real danger.
Swallowing the wrong way means inhaling food or liquid into the lungs instead of routing it down the esophagus into the stomach. Doctors call this aspiration, and it can cause respiratory infection or a frightening choking sensation. Also, when eating is laborious, it’s usually difficult for the person to take in enough calories to maintain weight. This is especially true if respiratory muscles are also weakened (which they usually are at this stage), requiring the person to expend enormous energy (burn calories) just to breathe.
A healthcare professional can instruct you on using soft or blenderized foods. When throat muscles weaken to the point where choking spells occur often and the patient is losing weight, his doctor will probably raise the question of a feeding tube, known as a gastrostomy tube. This is a tube that’s inserted directly into the stomach (or occasionally into the small intestine, in which case it’s called a jejunostomy tube). Then food can be put down a feeding tube.