Management of ALS

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Abstract
The nutritional needs of the ALS patient appear to be managed on an ad hoc common sense basis. In the experience of many neurologists, patients do not admit to eating difficulties unless questioned directly. Patients are not deceitful. They focus on their apparent success in consuming a meal, without consciously realizing that they have insidiously modified their eating patterns to accommodate advancing bulbar weakness. They become adept at avoiding choking by eating slowly and carefully. Because these strategies are generally effective in preventing choking, patients do not spontaneously admit to eating difficulties. However, the picture is different when talking to family. In general, they are concerned that the ALS patient is not eating enough of the right type of food and is losing weight.

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