What adjustments need to be made to food preparation in the event of a swallowing disorder in ALS?

Complicated” food components such as fruit peel, sausage skin, bread crusts etc. should be removed during preparation. Fruit, vegetables, bread etc. should be finely chopped, grated, grated or pureed before the meal. In the case of mild dysphagia, relief can be achieved by avoiding “problem foods” (grains, crusts, fibers and bones, etc.). In the case of moderate dysphagia (problems chewing and difficulty swallowing), the consistency of the food should be changed and a thick, mushy diet preferred (thickened soups, pudding, quark, yoghurt, ice cream, fruit purée, bread without crust, spreadable sausage, spreadable cheese, very soft potatoes, dumplings, puréed meat, puréed fish, meat loaf, sausages without skin).

High-calorie supplementary foods (“drinkable foods”) are also useful. In the case of a severe swallowing disorder (inability to chew and difficulty swallowing; repeated swallowing of the majority of foods and drinks), the diet should be further adapted (slightly thickened soups, fruit purees; mashed potatoes, noodles, pasta, vegetables, pulses; heavily thickened drinks). In this phase of dysphagia, additional food to drink is usually necessary, as otherwise a balanced diet and calorie balance can no longer be achieved.

In cases of severe restriction of food intake or loss of the ability to swallow (aphagia), feeding via a percutaneous endoscopic gastrostomy (PEG) is an important and established treatment option.