How does the swallowing disorder progress in ALS?

With incipient dysphagia (swallowing disorder), swallowing liquids is initially vulnerable and difficult. For example, “choking” when drinking is a typical early symptom. As a result, the swallowing of solid food components is restricted. The difficulties in placing, transporting and grinding food components make it necessary to adapt the selection and preparation of food.

A further increase in dysphagia leads to a disruption in the transportation of food and an increase in the duration of meals compared to the previous eating speed. The increased chewing, swallowing or breathing effort leads to a reduced ability to enjoy meals in some of those affected. In addition, there is the possible experience of stigmatization due to excess salivation (sialorrhea) and the altered chewing and swallowing process, which can also become visible to the outside world. This can lead to a tendency to withdraw at mealtimes and avoid eating in public (especially in large groups). Targeted nutritional therapy (speech therapy with swallowing training, supplementary nutritional drinks and the continuation of oral food despite PEG feeding – if possible) help to maintain meals, the ability to enjoy food and social participation.