Solving the Swallowing Problem: What Is the Science Behind Thickening Agents?

Thickening agents, which are often referred to simply as thickeners, are designed to help patients with dysphagia safely consume liquids without affecting their taste. Thickeners are often used not just in drinks but also in soups, sauces, and even puddings to reduce the risk of aspiration and subsequent medical complications.

What is Dysphagia?

Dysphagia is a medical term that describes a partial or total loss of the ability to swallow foods and liquids normally. It may be a symptom of certain neurological events or diseases like strokes, dementia, or head injuries or of other medical conditions, including cancer and gastro-oesophageal reflux disease (GORD). As the founder of Simply Thick knows, untreated dysphagia often causes aspiration of foods and liquids, which leads to more serious health complications including pneumonia, chest infections, and even death.

Thickeners Make Swallowing Easier

Thickeners are designed to turn liquids into gels, making them easier to swallow. They slow the transit of fluids through the mouth and throat, which helps patients with neurological or mechanical swallowing disorders coordinate the swallowing process more effectively to prevent aspiration. The exact mechanism by which they bind with water to create a gel, rather than a solid, differs based on the type of thickener used.

Starch-Based Thickeners

Starch-based thickeners contain modified cornstarch. The components of modified cornstarch include amylopectin, which binds with water to build viscosity over time. Unfortunately, amylopectin breaks down when it comes into contact with the enzymes in human saliva. This can be problematic for some dysphagia patients.

Gum-Based Thickeners

Gum-based thickeners use cellulose to bind with water and create gels. Cellulose is not susceptible to chemical alteration when it comes into contact with saliva, so it’s better for patients with severe dysphagia. It has no taste or color and can be mixed with just about any liquid, including acidic fruit juices that would break down starch-based thickeners over time.

Thickeners Prevent Dehydration and Malnutrition

Many dysphagia patients cut back on their consumption of food and fluids due to fears of aspiration. This often leads to malnutrition and dehydration, both of which can be very dangerous in patients whose health is already compromised. High-quality thickening agents are designed to increase the viscosity of liquids without reducing the bioavailability of water and nutrients, making it easier for patients to maintain adequate nutrition and hydration.

It’s important to note here that not all thickening agents are created equal. Those that have not been formulated specifically for use in treating dysphagia may affect the bioavailability not just of water and nutrients but also of medications taken with the thickened liquids. Only buy thickeners from companies that specialize in dysphagia products.

When to Use Thickeners

Any elderly person who is struggling to swallow should visit his or her doctor before starting a dysphagia diet that uses thickening agents. Symptoms of dysphagia include coughing, drooling, and regurgitation while eating. It can also cause pain while swallowing or a feeling that something is stuck in the throat or sternum. Dysphagia is typically a secondary disorder that results from other serious diseases or adverse health events, so most patients need only bring up their concerns with the doctor treating their other symptoms for a referral to a specialist.

The Bottom Line

Dysphagia is a dangerous and potentially fatal disorder. Medical science provides ample proof that switching over to a dysphagia diet that features thickened liquids is the best way to prevent aspiration and its complications.