People with SMA experience some gastrointestinal and nutritional complications caused by overall muscle weakness, which include feeding and swallowing problems, gastrointestinal dysfunction (with issues such as constipation, delayed stomach emptying, and severe reflux), growth and undernutrition and overnutrition problems, and respiratory problems due to aspiration and reflux.
Physicians indicate that management of these difficulties should include reducing the risk of aspiration with swallowing, optimizing efficient feeding, and promoting enjoyable meal times.
A semi-solid diet and thickened liquids can be a solution for chewing problems, reducing the time it takes to eat meals and protecting against aspiration of thin fluids.
Orthotic devices and varied seating positions also enhance the ability for SMA patients to eat on their own, and may improve swallowing efficiency and safety. If patients don’t get enough food orally, nutritional supplements may be needed, and this may require either a gastrostomy tube or a nasogastric tube.
Constipation is a frequently reported problem with those who have SMA, from several causes: abnormal gastrointestinal motility, reduced intake of dietary fiber, inadequate fluid intake, and low muscle tone of the abdominal wall. Constipation can lead to abdominal distention and bloating.
Management of reflux typically involves the use of acid neutralizers (magnesium or calcium carbonate) or inhibitors of acid secretion (famotidine, ranitidine, omeprazole). Short-term use of these agents is acceptable for symptomatic relief.
Use of probiotics such as acidophilus or lactobacillus help maintain a healthy gastrointestinal environment. Supplements to provide more than the recommended dietary intake for vitamins, minerals, proteins or fat should be discouraged in people with SMA.
Infants and children with SMA are less active, have less muscle mass, and use less energy. Therefore, they need fewer calories. Fewer calories are needed for them to achieve an acceptable rate of weight gain or growth in length.
Depending on the type of SMA, kids may be at risk of either under-nutrition or over-nutrition. For example, children with severe SMA type 1 or type 2 are more prone to undernutrition, which causes a failure to thrive. Children with strong SMA type 2 or type 3 are more likely to suffer from over-nutrition, which leads to being overweight or even obesity.
Because nutritional problems associated with SMA influence the patient’s pulmonary status and general well-being, optimal management by a multidisciplinary or interdisciplinary team of physicians, speech therapists or occupational therapists, dietitians, and pediatric surgeons should greatly improve survival and quality of life benefits such as:
- Improved growth — Gaining weight while growing in height is essential to good health. Having enough energy (calories) and protein helps keep the body growing by supporting lung tissue and the heart muscle.
- Better breathing — Growth in length helps with breathing, providing more room for the chest to expand. This is important because breathing problems are the leading cause of illness for children with SMA.
- Preventing illness — Adequate nutrition helps to prevent colds and viruses that could turn into potentially threatening lower respiratory infection in the lungs (pneumonia).
- Improved motor function — Too much weight or too little weight can cause children with SMA to decline in both strength and ability to move.
- Better quality of life — Poor nutrition can cause physical symptoms to become worse. Good nutrition can translate into better living.
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SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
