A patient with amyotrophic lateral sclerosis (ALS) may develop dysfunction of the gastrointestinal tract. This may be subclinical and detected only with specialized testing.
Patient selection: amyotrophic lateral sclerosis (ALS)
Potential gastrointestinal problems:
(1) dysphagia
(2) delayed gastric emptying
(3) delayed colonic transit time with or without clinical constipation
(4) chronic intestinal pseudo-obstruction syndrome
Causes:
(1) vagal dysfunction
(2) autonomic dysfunction
An affected patient may show other signs of autonomic dysfunction such as heart rate variability and a prolonged sympathetic skin response (SSR).
Non-autonomic factors that may contribute to constipation:
(1) dehydration
(2) poor intake of dietary fiber
(3) immobility
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Specialty: Gastroenterology, Neurology
