Starch-based Thickeners Research Articles

Thirstiness, body hydration and thickened water: A study about their relationship

When liquids are thickened to swallow safely, thirstiness sensation might not be quenched. In this study, we investigated how drinking water, thickened water, or not drinking influences body hydration and thirstiness sensation. Forty-one healthy participants attended four 3 h sessions with different stimulus provided: nothing, water, thickened water A (gum-based thickener), or thickened water B (starch-based thickener). The hydration status (oral moisture and urinary osmolality), self-reported dimensions (thirst sensation, dry mouth sensation, and desire to drink), and hunger feeling were measured at 0, 90, and 180 min, respectively; after 180 min, water was administered ad libitum. The results show no significant changes in oral mucosa hydration over time. The urine osmolality values showed differences in body hydration depending on whether they had ingested water and on the type of thickened water (lower for thickener B). Thirstiness, dry mouth, and the desire to drink water after having the stimuli differed significantly from when no stimuli were given. Low liking was related to longer consumption time and more swallows, especially for thickened water B. At the end of the study, beyond the differences among three behavioral clusters, ad libitum water intake increased if no stimulus or thickened water B were administered. Hunger sensation varied over time, but not among stimuli. In conclusion, in the fast situation (no drink), thickened water helped maintain body hydration, although compared to water it were more disliked and, in comparison with water, right after their consumption did not decrease the dry mouth sensation. Therefore, although thickeners seem effective for hydrating and calming thirstiness, their poor liking needs to be improved in the design of dysphagia thickeners to improve their diet adherence.

Effects of barium sulfate on rheological properties and IDDSI flow consistency of liquid stimuli prepared using commercial thickening powders.

During videofluoroscopic swallowing study (VFSS), barium sulfate (BaSO4 ) is commonly added into food samples as a radiopaque contrast media for bolus visualization and examination. Accordingly, the consistency and flow behavior of barium stimuli can differ significantly from their non-barium counterparts. Such differences may have a subsequent impact on the validity of VFSS. Therefore, in this study, effects of barium sulfate on the shear and extensional rheological properties and IDDSI (International Dysphagia Diet Standardization Initiative) flow consistency of liquids prepared using various commercial thickening powders were investigated. Results showed that all barium stimuli exhibited shear thinning behavior but with significantly higher shear viscosity compared to the non-barium counterparts. A shift factor of viscosity at shear rate 50 s-1 with values in range of 1.21-1.73 could be used to describe the increase in the viscosity for samples thickened with gum-based thickeners. However, the change in the viscosity was not invariant for the stimuli prepared starch-based thickener. The addition of BaSO4 had a negative impact on extensional properties of samples by demonstrating a faster filament rupture. The extent of impact on the decrease in filament breakup time was more pronounced in xanthan > guar gum ≈ tara gum-based thickeners. Based on the IDDSI flow test, no significant effect of BaSO4 was found on the gum-based thickeners, whereas there was a marked effect in the starch-based sample. These results can be used beneficially to assist clinicians in the dysphagia diagnosis for matching rheological properties of the barium stimuli to enhance effectiveness dysphagia interventions.

Pairing physical and sensory properties of dysphagia thickeners to understand disliking

Patients with dysphagia who adhere to drinking thickened water is still a challenge, as patients dislike it and it does not quench their thirst. The objective of this study was to relate the physical properties of six commercial thickeners based on gums, modified starch, or mixtures of modified starch and gums, to sensory characteristics and the liking and refreshing sensation. Therefore, viscosity, friction, adhesiveness, and firmness were obtained for all thickeners with and without artificial saliva. Sensory attributes for the six thickeners were obtained using the Flash Profile method; furthermore, acceptance and refreshing sensation were also studied. The results showed that high viscous thickeners without particle presence were preferred. These thickeners were gum-based and starch-dispersed, which were described as providing a viscous and smooth texture and being tasteless. Starch-based thickeners with starch granules with integrity had lower preference than gum-based or starch-dispersed thickeners, and were described as having a sandy and fluid texture, with an intense starch taste and aftertaste. Among the preferred thickeners (gum-based thickeners and starch-dispersed thickeners), a lower friction coefficient was related to a higher refreshing sensation, probably caused by a short oral residence.

The importance of shear and extensional rheology and tribology as the design tools for developing food thickeners for dysphagia management

Food texture manipulation and modification is a practical strategy to reduce the risk of aspiration for dysphagia management. Addition of thickening agent to thicken liquid can increase the bolus transit time, thus, potentially leading to safer swallowing. The important bolus characteristics for safe swallowing include viscosity, hardness, cohesiveness, and adhesiveness, which can be related to the rheological and tribological properties of bolus. Therefore, this work highlights the importance of shear and extensional rheology and tribology as the design tools for developing dysphagia food thickeners. A range of commercially available thickening powders (xanthan gum-, guar gum-, and modified starch-based) was studied to create baseline rheological and tribological data. In general, it was observed that the increase in thickener concentration led to increases in shear viscosity, viscoelastic properties, and extensional viscosity, but the impact on tribological behavior was varied depending on the type of thickener and lubrication regime. It was also revealed that, at the same liquid consistency based on IDDSI classification, xanthan gum-based thickener showed the highest low shear viscosity, extensional viscosity, and lubricating capacity than the other thickeners. More specifically, modified starch-based thickener showed the poorest extensional property and could be the least effective thickener for promoting safer swallowing. The proposed design tools may be used beneficially to tailor novel thickeners for dysphagia management based on the obtained baseline data. Nonetheless, in-depth knowledge on the relationship between these properties and in-vivo measurements of swallowing is still required and is key to achieve the most effective therapeutic strategy in the dysphagia treatment.

Rheological Properties and Stability of Thickeners for Clinical Use.

The adaptation of liquids for patients with dysphagia requires precision and individualization in the viscosities used. We describe the variations of viscosity in water at different concentrations and evolution over time of the three compositions of commercial thickeners that are on the market (starch, starch with gums, and gum). By increasing the concentration in water, the viscosity of gum-based thickeners increases linearly, but it did not reach pudding texture, whereas the viscosity of the starch-based thickeners (alone or mixed with gums) rapidly reaches very thick textures. We modeled the viscosity at different concentrations of the four thickeners using regression analysis (R2 > 0.9). We analyzed viscosity changes after 6 h of preparation. The viscosity of gum-based thickeners increased by a maximum of 6.5% after 6 h of preparation, while starch-based thickeners increased by up to 43%. These findings are important for correct handling and prescription. Gum-based thickeners have a predictable linear behavior with the formula we present, reaching nectar and honey-like textures with less quantity of thickener, and are stable over time. In contrast, starch thickeners have an exponential behavior which is difficult to handle, they reach pudding-like viscosity, and are not stable over time.

Effect of temperature on thickness of starch- and gum-based thickened liquids for dysphagic individuals

ObjectivesStudies have revealed that consistency of liquid food changes with temperature. Yet, the exact relationship between temperature and consistency of food bolus is still not known. The present study examined the change in liquid consistency with temperature. MethodsWater thickened at the four thickness levels (slightly thick, mildly thick, moderately thick, and extremely thick) using starch-based and xanthan-gum-based thickeners was studied. Consistency was measured using a Bostwick consistometer at different temperature points between 5 °C and 85 °C. Regression analyses were subsequently carried out. ResultsResults indicated definite but different relationships between temperature and consistency of thickened liquids prepared using starch- and gum-based thickeners. While there was a general trend of decreasing consistency in liquids prepared using gum-based thickener with temperature, a quadratic relationship between temperature and consistency was found for starch-based thickener. The consistency was generally the highest at very low and very high temperature, but the lowest at 65 °C. ConclusionFindings confirmed a definite effect of temperature on bolus consistency. When preparing thickened liquids for patients with dysphagia, caregivers and clinicians should take into consideration the effect of temperature, as it has a definite effect on liquid consistency.

Flow test by the International Dysphagia Diet Standardization Initiative reveals distinct viscosity parameters of three thickening agents.

The International Dysphagia Diet Standardization Initiative (IDDSI) flow test is useful for the global standardization of food consistencies of dysphagia patients. In clinical practice, different compositions of food thickeners are commonly used, directly influencing viscosity parameters and swallowing physiology. We aimed to compare the IDDSI thickness levels, remaining volume in the syringe (RVS), and viscosity parameters of three different food thickeners. As a secondary objective, we compared the cost of preparing 100mL of thickened drinks using the studied thickeners. Thickeners A (xanthan gum), B (corn starch, tara gum, xanthan gum, and guar gum), and C (corn starch) were prepared in increasing concentrations from 1 to 7g/100mL and were assayed in quintuplicate using the IDDSI flow test. Thickeners A, B, and C presented statistically different results for the IDDSI levels, RVS, and viscosity parameters at all concentrations. Thickener A reached higher levels in the IDDSI framework, RVS, and viscosity parameters compared with thickeners B and C. A large range of RVS was observed at different concentrations for thickener B compared with C. Regarding viscosity, thickeners B and C, with corn starch in their composition, showed exponential behavior as concentrations increased, while thickener A presented a linear trend. The thickener composition was significantly influenced by IDDSI classification, RVS, and viscosity parameters. The study shows that xanthan gum thickeners present less variability in IDDSI, RVS, and viscosity compared with starch-based thickeners.

The Effect of Food Thickeners on the Bitterness and Dissolution of Amlodipine Besilate Loaded Oral Disintegration Tablets: Assessment of Potential Suitability for Patients with Dysphagia

The purpose of this research was to evaluate the effect of starch- and xanthan gum-based food thickeners on the bitterness and dissolution of amlodipine besilate (AMPB) loaded orally disintegrating tablets (ODT) for potential use with patients with dysphagia. A conventional dissolution test simulating the oral cavity was performed and the taste sensor output of the dissolved sample was evaluated over a 60-seconds period. When four types of AMPB loaded ODTs were tested alone, at 60 seconds, branded product (A) was the least bitter, followed by generic product (B)/generic product (C) which were equal, and finally generic product (D) which was the most bitter. Inhibition of bitterness of AMPB loaded ODTs mixed thickeners, 1.0 (w/v) % xanthan gum-based food thickener solution was significantly strong. The 7.1 (w/v) % and 4.7 (w/v) % starch-based food thickeners solution also effective in bitterness inhibition compared to the 2.4 (w/v) % starch-based food thickener solution. The dissolution test under pH 1.2 in related to 7.1 (w/v) % and 4.7 (w/v) % starch-based thickener contained each of AMPB loaded ODTs were associated with an almost complete amlodipine (AMP) dissolution (almost 90% at 10 minutes), whereas the 1.0, 2.0, 3.0 (w/v) % xanthan gum-based food thickener solution containing AMPB loaded ODTs did not show complete AMP dissolution and there were large variations in the initial dissolution stage. This suggests that a mixture of xanthan gum-based thickener and AMPB loaded ODT poses a risk of reduction of bioavailability. In conclusion, a mixture of 4.7 (w/v) % or 7.1 (w/v) % starch-based thickener with ODTs provides complete release of AMP and superior bitterness inhibition, so is the best choice for administration to patients with dysphagia.

The Effect of Food Thickeners on the Bitterness and Dissolution of Amlodipine Besilate Powder When Co-Administered with Thickeners to Patients with Dysphagia

Purpose: The present research was performed to evaluate the effect of food thickeners on the bitterness and dissolution of bitter drugs when co-administered to patients with dysphagia. Methods: Amlodipine besilate (AMPB) powder was used as a model drug. Starch- and xanthan gum-based food thickeners were examined, with swallowing-aid jelly as a reference. The line-spread test (LST), texture prolife analysis (TPA) were done firstly. In related to AMPB powder mixed with food thickeners solution, a conventional dissolution test simulating the oral cavity was performed, the amlodipine (AMP) concentration and taste sensor output for dissolved medium versus time profiles were developed. The dissolution test at pH 1.2 and 4.5, representing typical gastric conditions for younger or elderly people, was performed in two kinds of thickener solution and swallowing-aid jelly those were mixed with AMPB powder. Results: LST demonstrated that xanthan gum-based food thickeners fulfilled the requirements for patients with dysphagia but that starch-based food thickeners did not. In TPA, hardness and adhesiveness decreased proportionally as the concentration increased for both kinds of food thickener. Conventional dissolution test simulating oral cavity demonstrated the following bitterness ranking: xanthan gum-based food thickener < starch-based food thickener < swallowing-aid jelly. In dissolution test at pH 1.2 and 4.5, starch-based thickener and swallowing-aid jelly mixed with AMPB powder showed complete AMP dissolution. However, xanthan gum-based food thickeners mixed with AMPB powder showed about only 60% AMP dissolution after 120 minutes. Conclusion: Although xanthan gum-based food thickeners were successful in masking the bitterness of AMP, they may reduce its bioavailability in humans. The 7.1 and 4.7 (w/v) % starch-based thickener show bitterness inhibition under simulated oral cavity conditions and complete dissolution of AMP under simulated gastric conditions.

How Accurate Are the Consistency Labels Used in Hong Kong? An Objective Study of the Consistency of Thickened Liquids Using International Dysphagia Diet Standardisation Initiative and Consistometric Measurements

Objectives: The present study objectively examined the consistency (thickness) of labels that are used in Hong Kong for the population with dysphagia using an International Dysphagia Diet Standardisation Initiative (IDDSI) flow test and Bostwick consistometric measurements. Methods: Liquids were prepared by thickening water to achieve 4 consistency labels (slightly thick, mildly thick, medium thick, and extra thick) according to manufacturer’s instructions, employing 2 types of thickening products that are used in Hong Kong, i.e., starch based and gum based. For each consistency label prepared using each thickening product, the IDDSI flow test and consistometric measurements were obtained and compared. Results: The results showed that the actual thickness of liquids was highly dependent on the type of thickener (starch based vs. gum based) used. Thickened liquids prepared using the starch-based thickener were generally thinner than the actual value at a lower concentration. Conclusion: Though prepared strictly following the manufacturer’s instructions, the thickened liquids fail to faithfully correlate with the standardized norms established according to the IDDSI framework and the objective consistometric measurement using a Bostwick consistometer. Therefore, caution must be exercised when administering a thickened diet following the manufacturer’s instructions for patients with dysphagia.

Laboratory study on bacteriological aspects of beverages and thickeners for dysphagia patients : Growth survey of Escherichia coli on thickeners and beverages

Currently, there is little evidence-based guidance on bacteriological aspects of thickeners or beverages for dysphagia patients in Germany that can be recommended to prevent aspiration pneumonia. Therefore, the aim of this study was to evaluate the lowest cell amount of E.coli on M9 agar media with beverages and thickeners. In the laboratory experiment 1 · 107 cells of E.coli were plated on adefined minimal medium (M9 agar plates) with different carbon sources and incubated at 37 °C for 2 days. The increase in cell number was determined using aphotometer. Carbon sources were water, beer, orange juice, thickened beer, maltodextrin-xanthan gum-based thickeners, corn starch-based thickeners and potato starch-based thickeners. The lowest E.coli cell amount was measured on water compared to beer, orange juice and all thickeners. A higher E.coli cell count was measured on maltodextrin-based thickeners than on potato starch-based and corn starch-based thickeners. In the present laboratory experiment, no individual risk factors for the development of aspiration pneumonia in humans were considered; however, initial bacteriological evidence for dysphagia patients could be collected. Due to the high growth of E.coli on maltodextrin, yeast, fructose and glucose, these ingredients should be used with caution by dysphagia patients. Further research on thickeners and beverages is needed to make acomprehensive recommendation for action in this aspect.

Dysphagia management in Parkinson's disease: Comparison of the effect of thickening agents on taste, aroma, and texture.

Dysphagia is a frequent symptom in Parkinson's disease (PD). Thickening liquids facilitates safe swallowing, however, low treatment compliance is a major issue, due to patients' dislike of thickened liquids. Some studies suggest a negative impact of gum-based thickeners, currently most used in clinical practice, on sensory properties compared to starch-based thickeners. This has not yet been investigated in PD. This study's aim was to compare taste, texture, and aroma of gum-based and starch-based thickened soups in participants with PD. Gum-based resource thicken up clear (RTUC) and starch-based kitchen products potato starch (PS) and quinoa flour (QF) were evaluated in broccoli soup. Texture, aroma, and taste were characterized by rheology, volatile, and sensory profiling. Thickened soups were evaluated in participants with PD and controls through a paired comparison test. Reduced release of 61.4%, 46.2%, and 38.5% of volatiles was observed after thickening with RTUC, PS, and QF, respectively. Overall taste intensity was reduced in RTUC- and PS-thickened soup, respectively. Taste and aroma of PS-thickened soup were considered more intense by 70.3% and 63.8% of all participants, respectively (n = 36 PD, n = 41 controls), 56.3% preferred the PS-thickened soup's texture . Taste and aroma of QF-thickened soup were considered more intense by 68.1% and 65.6% of all participants, respectively (n = 47 PD, n = 31 controls), 58.0% preferred the QF-thickened soup's texture. Starch-based thickeners demonstrated higher taste and aroma intensity. However, volatile and sensory profiling demonstrated reduced taste and aroma in all thickeners. Combining kitchen products with flavor enhancers may increase palatability of thickened beverages.

Variations in Hyoid Kinematics Across Liquid Consistencies in Healthy Swallowing.

PurposeJudgments regarding hyoid movement are frequently included in evaluations of swallowing. However, the literature lacks reference values for measures of hyoid kinematics in healthy swallowing. This study explores hyoid movement across the continuum from thin to extremely thick liquids.MethodParticipants were 39 healthy adults under the age of 60 years (19 men) who underwent videofluoroscopy involving three sips each of 20% w/v thin barium and six sips each of slightly, mildly, moderately, and extremely thick barium. Half of the thickened stimuli were prepared using xanthan gum; and half, with a starch-based thickener. Sip volume was derived from pre- and post-sip cup weights. Hyoid position was tracked frame-by-frame relative to the anterior–inferior corner of C4. Measures of peak hyoid position (along the XY axis) were normalized to a C2–C4 scalar, and measures of time-to-peak position, speed, and time-to-peak speed were derived. As a first step, Spearman's correlations confirmed the influence of sip volume on these hyoid measures. Linear mixed-effects models then explored the effects of stimulus, sip volume, and task repetition on the dependent variables.ResultsThe data set comprised 975 swallows with available hyoid tracking data. Sip volume was correlated with peak hyoid XY position (rs = .15, p < .01), time-to-peak position (rs = −.15, p < .05), and speed (rs = .13, p < .01). No significant differences in hyoid kinematics were found across stimuli.ConclusionMeasures of hyoid movement in healthy swallowing remain stable across the range from thin to extremely thick liquids with no systematic alterations in hyoid position or kinematics.

The Swallowing Characteristics of Thickeners, Jellies and Yoghurt Observed Using an In Vitro Model

Drinks and foods may be thickened to improve swallowing safety for dysphagia patients, but the resultant consistencies are not always palatable. Characterising alternative appetising foods is an important task. The study aims to characterise the in vitro swallowing behaviour of specifically formulated thickened dysphagia fluids containing xanthan gum and/or starch with standard jellies and yoghurt using a validated mechanical model, the “Cambridge Throat”. Observing from the side, the model throat can follow an experimental oral transit time (in vitro-OTT) and a bolus length (BL) at the juncture of the pharynx and larynx, to assess the velocity and cohesion of bolus flow. Our results showed that higher thickener concentration produced longer in vitro-OTT and shorter BL. At high concentration (spoon-thick), fluids thickened with starch-based thickener showed significantly longer in vitro-OTT than when xanthan gum-based thickener was used (84.5 s ± 34.5 s and 5.5 s ± 1.6 s, respectively, p < 0.05). In contrast, at low concentration (nectar-like), fluids containing xanthan gum-based thickener demonstrated shorter BL than those of starch-based thickener (6.4 mm ± 0.5 mm and 8.2 mm ± 0.8 mm, respectively, p < 0.05). The jellies and yoghurt had comparable in vitro-OTT and BL to thickeners at high concentrations (honey-like and spoon-thick), indicating similar swallowing characteristics. The in vitro results showed correlation with published in vivo data though the limitations of applying the in vitro swallowing test for dysphagia studies were noted. These findings contribute useful information for designing new thickening agents and selecting alternative and palatable safe-to-swallow foods.

Through Thick and Thin: The In Vitro Effects of Thickeners on Infant Feed Viscosity.

Gastroesophageal reflux disease (GERD) is a common problem in neonates, and current modalities for thickening human milk produce inconsistent outcomes. The objective of this in vitro study is to measure the viscosity effect of different thickening strategies. We thickened donor human milk (DHM) and formula using various thickeners: starch-based thickeners (SBT; Thick It, rice cereal), and gum-based thickeners (GBT; xanthan gum: Simply Thick, Thicken Up Clear; carob gum: GelMix). We also assessed formula with added starches marketed for reflux, including Similac Spit Up (SSU) and Enfamil AR (EAR). The viscosity of each sample was measured over time using a rotary viscometer. Additional variables, including acidity, temperature, and the addition of human milk fortifier, were tested. Formula can be effectively thickened with all tested thickeners, but the viscosities of thickened formula increase over time. On the other hand, DHM does not effectively thicken with SBT. Autoclaving DHM inactivates digestive enzymes, thus allowing SBT to successfully thicken autoclaved DHM. GBT effectively thickened both DHM and formula but reached higher viscosities than intended based on manufacturer recommendations. Adding acid to xanthan-gum thickened DHM resulted in phase separation and formation of solid precipitant. Current thickening strategies of preterm infant feeding produces highly variable results in final feed viscosity. The unpredictable properties of gum-based thickeners raise questions about their safety profile. Objective measures of liquid viscosity and careful consideration of acidity and time are recommended for adequate comparisons of thickening regimens. Human milk continues to be the most challenging feed type to thicken.

Gellan gum: A new member in the dysphagia thickener family

In this study, gellan gum (GG) (0.075–0.3 wt%) is proposed as a new dysphagia thickener and compared against commercial starch-based thickeners (modified starch with or without gums, 5 wt%) and xanthan gum (XG, 0.5–1.0 wt%) using apparent viscosity, oral tribology using polydimethylsiloxane (PDMS) ball-on-disc set up and ζ-potential measurements. The measurements were conducted in presence of artificial saliva containing mucin with or without α-amylase at 37 °C. Viscosity results suggested that the commercial starch-based thickeners behaved like water in orally relevant shear, largely associated with the hydrolysis of modified starch by α-amylase, whereas, XG and GG showed no responsiveness to α-amylase. In the case of oral tribology, artificial saliva containing mucin adsorbed to the PDMS surfaces reducing friction as compared to water. The increase in boundary friction coefficients in commercial starch-based thickeners was likely associated with α-amylase-induced hydrolysis, increasing the PDMS-PDMS asperity contacts. Interestingly, the tribological behaviour of XG and GG was dictated mainly by viscous lubrication. However, in simulated oral conditions, the increase in friction coefficients in presence of XG and GG was influenced by depletion of artificial saliva from the PDMS surfaces due to electrostatic interaction between the gums and mucin. A combination of rheological and tribological techniques in orally relevant conditions appears as a reliable approach to understand the potential of GG (0.3 wt%) to act as a dysphagia thickener that offers similar mechanical properties as XG (1.0 wt%) at a lower concentration. Extensional viscosity measurement of GG is needed to understand its applications in dysphagia management.

Sensory perception and flow properties of dysphagia thickening formulas with different composition

Among the hydrocolloids used as thickeners for dysphagia, xanthan gum has gained importance in the last years. This work studies the sensorial perceived differences and flow behavior between ascending concentrations for both, a gum-based commercial thickener and a traditional starch-based product. Sensorial discriminant analysis was performed by a panel of untrained assessors (1:3 men to women ratio and 1:1 < 50 years and >50 years). The accuracy of the panel and the possible effects of age or gender were monitored. The physical properties of both thickeners were studied by a syringe flow test, at 0, 10 and 30 min from mixing. The panel probed to be repetitive and reproducible and no significant effect of gender or age was detected. In general, it was possible to discriminate significantly among concentrations half-narrower than those usually proposed by commercial brands. For both products, it became more difficult to discriminate between consistency changes at the higher concentrations. Panelists ranked the ascending concentrations unevenly, with a linear trend for the lowest concentrations, which also showed wider relative perceived distances. Thickening formulas behave differently in the syringe flow test. Starch-based thickener showed in general higher values than expected, while lowest categories (thin and slightly thick) were difficult to achieve. The gum-based thickener had a more gradual behavior. Time from mixing affects the flow test results. In conclusion, starch- and gum-based thickeners cannot be used as equivalent products. Taking into account both discriminant capacity and preparation variables, such as time from mixing, lower product amounts could possibly be prescribed to achieve adequate consistencies for dysphagia treatment.

Time-Dependent Rheological Behavior of Starch-Based Thickeners and Herb Infusion Dispersions for Dysphagia Management

Time-Dependent Rheological Behavior of Starch-Based Thickeners and Herb Infusion Dispersions for Dysphagia Management

Tolerability and Product Properties of a Gum-Containing Thickener in Patients With Dysphagia.

The aim of the study was to determine the gastrointestinal (GI) tolerability of drinks and foods thickened with a gum-containing thickener compared to a starch-based thickener in patients with dysphagia. A randomized, double-blind, controlled, parallel group study. Subjects started with a 3-day run-in period on a starch-based thickener and continued with a 14-day intervention on either the starch-based or gum-containing thickener. GI tolerance parameters were recorded at baseline and for three consecutive days in both weeks. Product properties were studied using a feedback questionnaire from carers. Incidence and intensity of GI symptoms was low and not significantly different between groups. Carers indicated that starch-thickened drinks became significantly thinner with time compared to gum-containing thickened drinks (p = .029). No differences in GI tolerance parameters between groups were observed. We hypothesize that use of the gum-containing thickener is preferred to a starch-based thickener due to the stability of its viscosity during consumption.

Sometimes Treatment Is Hard To Swallow

Sometimes Treatment Is Hard To Swallow