Living With ALS

Eating & Swallowing

Eating and swallowing changes can affect safety, hydration, nutrition, energy, and enjoyment. A speech-language pathologist and dietitian can help tailor recommendations.

Start with the problem

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This question box finds a relevant ALS Hub page. It does not diagnose or provide medical advice.

Signs to bring to the care team

  • chewing fatigue
  • coughing during meals
  • choking
  • changes in food textures
  • meal fatigue
  • unintentional weight loss
  • dehydration
  • difficulty taking medications

Sources: Nutrition and feeding tubes · Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis

Swallowing safety

A swallowing evaluation can help identify aspiration risk and whether changes to food textures, liquids, positioning, pacing, or assistance may be appropriate. Thickened liquids or other changes should be used only when clinically recommended.

Sources: Nutrition and feeding tubes · Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis

Nutrition and hydration

The care team may monitor calorie intake, hydration, weight maintenance, meal fatigue, and the amount of time eating takes. A dietitian can help identify ways to support nutrition while preserving safe and meaningful oral intake when possible.

Sources: Nutrition and feeding tubes

Speech-language pathology and dietitian support

Do not rely on a general online instruction to manage an individual swallowing problem. Ask a qualified speech-language pathologist and dietitian to assess the person’s symptoms, goals, and safest options.

Sources: Nutrition and feeding tubes · Feeding tubes

Feeding tubes

PEG, RIG, or PRG procedures may be discussed when swallowing, hydration, nutrition, or medication access becomes difficult. Timing is individualized and should be discussed before a crisis.

  • PEG tube
  • RIG / PRG tube
  • G-tube
  • low-profile gastrostomy button where appropriate
  • feeding pump and supplies

Sources: Nutrition and feeding tubes · Feeding tubes

Medications and oral intake

Some medications may be given through a feeding tube, but the specific medication and tube must be reviewed by the prescribing clinician or pharmacist. Oral intake may continue when it is considered safe and consistent with the person’s goals.

Sources: Feeding tubes · Practice Parameter update: The care of the patient with amyotrophic lateral sclerosis

Sources & Further Reading

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This information is for education and does not replace individualized medical advice, diagnosis, treatment, or emergency care.

Last reviewed: 09-30-2026

Medical information should be reviewed periodically as guidance, benefits, and equipment options change.