Clinical Pearls

Secretion Management in Amyotrophic Lateral Sclerosis

Elyse Aufman Everett, MD MOT

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder that leads to death primarily from respiratory failure due to respiratory muscle weakness. Difficulty managing secretions is a common symptom in patients with ALS that can pose a challenge to treat effectively. It is important to recognize that there are two different types of secretions in patients with ALS—sialorrhea and thick mucous—as management differs significantly between them. Patients need to be specifically asked about secretions, as they may not spontaneously report this symptom, and further questions about timing and quality of secretions are necessary to distinguish between the types and determine best avenues for treatment. All patients with secretions should be given a suctioning device to help clear their mouth and throat.