As the muscles that control chewing and swallowing weaken, eating and drinking
become more difficult, until theyre 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 arent
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, its 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 thats inserted directly into the stomach (or occasionally
into the small intestine, in which case its called a jejunostomy
tube). Then food can be put down a feeding tube.