ALS feeding tube

ALS Feeding Tubes

ALS feeding tubes are used to provide nutrition, medicines and water to the individual in the later stages of the disease. Using a feeding tube is advisable once swallowing and chewing become too difficult and it can be administered either through a tube in the mouth down to the stomach or through the skin into the stomach wall itself.

A progressive neurodegenerative disease like Amyotrophic Lateral Sclerosis (ALS) requires constant and careful management, particularly as the symptoms begin to get worse.

ALS affects the nerves in the body, gradually breaking them down and destroying them. Whilst the symptoms associated with the disease may start in one particular location in the body, such as the hands or legs, it gradually spreads to affect just about every organ and muscle.

Once damage occurs, any area that is being served by nerves will be severely affected. For example, a muscle will become weak and unable to contract or relax to move body parts.

Paralysis is the final result of the progression of ALS in its later stages. The disease can also affect areas we generally take for granted but which involve complex muscle groups, such as breathing and eating.

Why Swallowing Becomes an Issue for ALS Patients

Both talking and swallowing are controlled by muscles in the mouth and throat. One of the major symptoms of ALS is a gradual weakening of these muscles to the extent that it becomes very difficult to swallow food.

In the early stages of ALS, this might be helped by making careful diet choices and switching to foods that are easy to swallow or don’t require a lot of chewing. In the later stages of the disease, reliance on a feeding tube is typically only option available.

ALS Feeding Tubes

Percutaneous Gastrostomy Tube
Percutaneous Gastrostomy Tube (PEG)

ALS feeding tubes are used once the individual is unable to swallow and is having difficulty taking in food of any kind. There are two different types of feeding tube which work to deliver liquid food directly to the stomach:

  • Percutaneous Endoscopic Gastrostomy (PEG): This type of tube is inserted using the help of an endoscope.
  • Radiologically Inserted Gastrostomy (RIG): This type of tube is inserted using the guidance of an x-ray.

When to Consider a Feeding Tube

If the individual is not getting sufficient nutrition or hydration, it could be because they are simply finding it too difficult to swallow. ALS also affects the ability of someone to chew properly which makes eating, in general, more difficult.

Some individuals with ALS quickly become tired when they try to eat – the process of lifting a spoon or fork or the chewing of food can be very difficult in ways that most of us cannot imagine. If eating a meal is taking more than 45 minutes and there is constant trouble swallowing, many individuals will consider a feeding tube as a less time consuming and less traumatic solution.

In some cases, an individual will have a feeding tube put in to provide additional nutrients while also normally eating the foods they can still swallow properly.

An ALS feeding tube will usually be recommended if the individual begins to lose significant weight or appears malnourished or dehydrated. Difficulty with breathing may also compound feeding issues, especially when food is suspected of going down the windpipe into the lungs.

In accordance with this, it’s usually advised to have an ALS feeding tube put in before lung capacity drops below 50% in order to avoid complications.

Advantages of Using a Feeding Tube

There are numerous advantages for introducing a feeding tube for an individual in the later stages of ALS. The first, of course, is to ensure that they get adequate nutrition and hydration.

  • A feeding tube reduces the chance that someone will choke on their food and removes having to cope with swallowing problems which can be difficult and challenging.
  • A feeding tube also reduces the risk of infections such as aspiration pneumonia and can also be used to administer medicines more safely.
  • An individual may have concerns about putting in a feeding tube, including the fact that it is a surgical procedure and there is a risk of infection.
  • The advantages of a feeding tube, however, far outweigh any concerns and, in the latter stages of the disease, it is the only way to get sufficient hydration and food to the individual.

Feeding Tubes and Medication

ALS feeding tubes can also be used to administer medication. There are a number of issues to be aware of, however.

  • The first is to use liquid medications as much as possible.
  • If a pill is to be administered, it needs to be crushed up finely and mixed with warm water.
  • The feeding tube should flushed with about 20-30 ml of water before and after the administering of any medicine.