Weight Loss and Dysphagia in Patients With ALS
Weight Loss and Dysphagia in Patients With ALS
The significance of the present study is limited because it is retrospective and based on subjective data from the patients themselves. Nevertheless it provides valuable information that can be used as a starting point for further prospective investigations.
Even though malnutrition is a significant and independent prognostic factor in survival, it is often inadequately addressed in clinical practice. According to our results the effect of high calorie nutritional supplements and PEG is often higher than expected. Patients, caregivers and physicians should therefore be encouraged to consider these measures. However, their benefit still requires further confirmation by prospective studies.
To evaluate the reasons of weight loss beside dysphagia, further prospective analysis of patients without weight loss in comparison to patients suffering from weight loss not attributable to dysphagia, comparing clinical parameters such as fasciculations, spasticity and cognitive or behavioural abnormalities together with REE and FVC will certainly provide more thorough understanding of this phenomenon. In any case the existence of these different phenotypes highlights once more the heterogeneity in the clinical presentation of ALS.
Regarding dietary supplements, further studies are needed to evaluate the safety and efficacy of numerous dietary supplements and to enable appropriate recommendations.
Conclusion
The significance of the present study is limited because it is retrospective and based on subjective data from the patients themselves. Nevertheless it provides valuable information that can be used as a starting point for further prospective investigations.
Even though malnutrition is a significant and independent prognostic factor in survival, it is often inadequately addressed in clinical practice. According to our results the effect of high calorie nutritional supplements and PEG is often higher than expected. Patients, caregivers and physicians should therefore be encouraged to consider these measures. However, their benefit still requires further confirmation by prospective studies.
To evaluate the reasons of weight loss beside dysphagia, further prospective analysis of patients without weight loss in comparison to patients suffering from weight loss not attributable to dysphagia, comparing clinical parameters such as fasciculations, spasticity and cognitive or behavioural abnormalities together with REE and FVC will certainly provide more thorough understanding of this phenomenon. In any case the existence of these different phenotypes highlights once more the heterogeneity in the clinical presentation of ALS.
Regarding dietary supplements, further studies are needed to evaluate the safety and efficacy of numerous dietary supplements and to enable appropriate recommendations.
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