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Maintaining nutrition

Some weight loss is an inevitable consequence of muscle wasting. However as motor neurone disease progresses, eating may become difficult and exhausting, and cause anxiety (MND Australia 2014).

Consult a dietitian for advice on maintaining optimal nutrition and hydration.

It is generally recognised that malnourishment is a relevant determinant of outcome in ALS (Chio and others 2009).

Miller and others 2009a

In ALS, factors that restrict adequate nutrition develop insidiously and progressively worsen.

Videofluoroscopic evaluation of the swallowing mechanism may identify food textures that can be handled successfully.
However, it is not a required test to establish the presence or absence of dysphagia.

Strategies to maintain oral nutritional intake consist of altering food consistency and using nutritional supplements.

Ultimately, a percutaneous endoscopic gastrostomy (PEG) or equivalent device (e.g., radiologically inserted device [RIG]) may be needed as an alternative route for delivering nutrition. It is important to emphasize to patients that PEG does not eliminate oral feeding but offers a convenient method for administering medication and fluid and stabilising weight.

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