The dietary management of patients with Amyotrophic Lateral Sclerosis (ALS) , presenting symptoms of dysphagia must ensure the maintenance of adequate nutrition to energy needs, protein, water, minerals and vitamins in the security situation, that is, preventing the passage of solid food and / or liquids into the airways.
The patient should be given the opportunity to choose the appropriate foods and to use specific techniques to increase the share of calories - protein and to improve the swallowing function. Nutrition orally from physiological point of view is obviously the first choice not only because it is physiological, using the intestine, but the foods themselves, constitute an essential factor for maintaining the functional integrity of all functions intestinal hormones, immune barrier. Furthermore, oral ingestion of food triggers the cephalic phase of food, useful not only to the subjective feeling of the subject, but also for stimulation of all gastro-enteric secretions. If oral feeding alone is not sufficient to cover the required energy and protein of the patient, you can combine the use of food supplements on the market or artificial enteral nutrition.
The dysphagia for liquids is considered separately, because there may be a normal ability to feed orally associated with inability to exclusive 'fluid intake. The enteral nutrition is the system of choice when it is necessary to use artificial feeding. In patients with swallowing problems can have this nutritional support has substantially changed the course of the disease and prospects for survival.
Although a system of artificial nutrition that respects the physiology of the intestine, with low risks and complications, however, must be managed in an appropriate manner, preferably by trained personnel. We should not ever forget that, although the techniques have improved considerably in recent years and are currently available equipment, aids and materials experienced long, artificial feeding is a total artificial organ replacement and as such, if handled incorrectly may also be due to iatrogenic damage serious.
enteral nutrition, is used when the patient is unable to eat enough orally (dysphagia partial), or when the dysphagia is total (acute dysphagia). Enteral nutrition may also be associated with oral feeding, when the patient is still able to eat orally, but only partially. Since the nutritional problems of patients with ALS complex and multifactorial, it is necessary that they are managed by a multidisciplinary team with specific skills and experience (nutritionist, dietitian, speech therapist, neurologist).
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