Do ALS patients have special nutritional needs?
We don’t know how many calories to add if you have a lot of nonfunctional muscle contractions, such as fasciculations, cramps or spastic muscle tone. On the other hand, if you’re not as physically active, that factor suggests a reduced caloric need. The balance between the two is hard to predict. In our study we’re trying to develop a specific equation to predict the caloric needs in ALS on a patient-by-patient basis. Q: Is a PEG — percutaneous endoscopic gastrostomy — tube the solution to taking too long to eat and falling behind on calories? A: A PEG tube is a means to an end. It gives you a second route to maintaining nutrition. Q: Does it also protect against inhaling food or liquids into the lungs (aspiration)? A: When I first went to work on the practice parameter, everybody said that PEG would prevent aspiration, but actually, it doesn’t really do that. Some of the aspiration comes from saliva, so you can still get aspiration pneumonia [infection from nonsterile material in the
