[Dysphagia] use of papaya extract in ALS

[MWagg at doh.health.nsw.gov.au (Mary Wagg)]

Dear all
One of the patients in our ALS clinic is having huge problems with
mucus production.  As soon as he has any oral intake (even a few sips of
water) or any intake via the PEG he begins to produce large amounts of
mucus that he can't, due to his advanced bulbar symptoms, poor cough,
and the mucoid nature of the secretions, clear effectively.  As a
result, his intake even via PEG is reduced because of a feeling of
suffocation with intake.

He is having Nexium via the PEG, and more recently has added Gaviscon
prior to introduction of the feed.  The Gaviscon seems to have helped
somewhat.  Oral suction as a last resort has also given some relief.

Can anyone tell me if papaya extract via the PEG is as useful as PO? 
He is unable to tolerate dark grape juice orally in sufficient amounts
to be helpful.

Many thanks for your input

Mary



Mary Wagg
Speech Pathologist
Royal North Shore Hospital
St Leonards NSW 2065
ph: 9926 7741
email: mwagg@doh.health.nsw.gov.au

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