Lisping could be first sign of ALS

DEAR DR. ROACH

>> My mother-inlaw died at age 73 from amyotrophic lateral sclerosis (ALS). There was no family history of the disease. My sister-in-law, age

72, is now experiencing occasional problems with lisping. Could this be the first sign of her developing familial ALS?

ALS, sometimes called Lou Gehrig’s disease, is a disease of the parts of the brain and spinal cord that are responsible for movement. The most common initial symptom is weakness, usually more on one

DEAR READER >>

— Anon. side than the other and typically in an arm or a leg. However, 20% of people will have symptoms in their muscles of eating and speaking, so it is unfortunately possible that lisping could represent the onset of muscle weakness in the lips and tongue.

Cases can occur as young as 20 and as old as 87.

I’d recommend that your sister finds a neurologist specifically trained in neuromuscular diseases.

In 2018, at age 86, I had a colonoscopy where some benign

DEAR DR. ROACH >>

polyps were found. I was recommended to come back in three years for another colonoscopy, but in 2021, procedures were not being done because of COVID. Once they started doing them again, I consulted with my primary care doctor. We decided not to do the colonoscopy.

Recently, my bowel movements have changed, becoming less frequent and more difficult. I don’t have blood in my stool and have taken the fecal occult blood test with negative results. Are there any other tests that you recommend? — J.K.

DEAR READER >> Although a screening colonoscopy is not usually recommended in people over 85, there are sometimes reasons to do them, such as in an extraordinarily healthy person with a family history of colon cancer. However, the issue for you is no longer about screening; it is about finding out why you are having these symptoms.

Any change in bowel habits, especially in older individuals, should get your physician to think that there might be a new medical problem.A consultation with your gastroenterologist could be appropriate, but a colonoscopy still might be the best test.