In ALS and other degenerative neuromuscular disorders one loses the ability to swallow effectively and protect against aspiration along with the inability to sp

In ALS and other degenerative neuromuscular disorders one loses the ability to swallow effectively and protect against aspiration along with the inability to speak. People affected by this, like my grandfather, will usually require a feeding tube to allow enough calories without risking aspiration. However, even with this, we are constantly relying on our epligottis and swallowing reflexes to prevent microaspirations of saliva and oral bacteria. Because of this, people with ALS are at extremely high risk for pneumonia, which would be my first guess as being most likely. His was lucky in that his ALS was a subtype that didn't progress as rapidly as most do. I think you don't deserve the downvoting you are getting even though the timing of your question is not great, you're still trying to understand what the natural progression of ALS is.