Breathing and Nutritional Assistance for ALS
Nutritionists can help people with ALS and their caregivers plan and prepare numerous small meals throughout the day that provide enough calories, fiber, and fluid. Nutritionists can also teach how to avoid foods that are difficult to swallow.
People may begin using suction devices to remove excess fluids or saliva and prevent choking. When they can no longer get enough nourishment from eating, doctors may advise inserting a feeding tube into the stomach, which reduces the risk of choking and pneumonia that can result from inhaling liquids into the lungs. The tube is not painful and does not prevent people from eating food orally.
When the muscles that assist in breathing weaken, nocturnal ventilator assistance may be used to aid breathing during sleep. Such devices artificially inflate the lungs from various external sources that are applied directly to the face or body. When muscles are no longer able to maintain oxygen and carbon dioxide levels, these devices may be used full-time.
People may eventually consider forms of mechanical ventilation (respirators) during later treatment of ALS. This type of machine inflates and deflates the lungs. To be effective, this may require a tube that passes from the nose or mouth to the windpipe (trachea).
For long-term use, an operation such as a tracheostomy, in which a plastic breathing tube is inserted directly into the windpipe through an opening in the neck, may be needed.
People living with ALS and their families should consider several factors when deciding whether and when to use one of these options. Ventilation devices differ in their effect on quality of life and in cost.
Although ventilation support can ease problems with breathing and prolong survival, it does not affect the progression of ALS. People need to be fully informed about these considerations and the long-term effects of life without movement before they make decisions about ventilation support.