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The effects of a xanthan gum‐based thickener on the swallowing function of patients with dysphagia
Author(s) -
Rofes L.,
Arreola V.,
Mukherjee R.,
Swanson J.,
Clavé P.
Publication year - 2014
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12696
Subject(s) - dysphagia , swallowing , medicine , bolus (digestion) , oropharyngeal dysphagia , fluoroscopy , anesthesia , surgery
Summary Background Increasing bolus viscosity of thin liquids is a basic therapeutic strategy to protect patients with oropharyngeal dysphagia ( OD ) from aspiration. However, conventional starch thickeners increase post‐deglutitive residue. Aim To assess the therapeutic effect of a new xanthan gum‐based thickener, Resource ThickenUp Clear (Nestlé Health Science, Vevey, Switzerland) on patients with oropharyngeal dysphagia. Methods We studied the effect of Resource ThickenUp Clear using a clinical method and videofluoroscopy on 120 patients with oropharyngeal dysphagia (66 with stroke, 41 older and 13 with neurodegenerative diseases) and 14 healthy volunteers while swallowing thin‐liquid, nectar‐like and spoon‐thick boluses. We assessed the prevalence of signs of impaired safety and efficacy of swallow and the physiology of the swallow response. Results Increasing bolus viscosity with Resource ThickenUp Clear: (i) improved safety of swallow demonstrated by a reduction in the prevalence of cough and voice changes in the clinical study and penetrations and aspirations during video fluoroscopy. Prevalence of aspirations was 12.7% with thin liquid, 7.7% with nectar‐like ( P < 0.01) and 3.4% with spoon‐thick ( P < 0.01) viscosities. Penetration–Aspiration Scale was reduced from 3.24 ± 0.18 at thin liquid to 2.20 ± 0.18 at nectar‐like ( P < 0.001) and to 1.53 ± 0.13 at spoon‐thick ( P < 0.001) viscosities; (ii) did not enhance pharyngeal residue; (iii) nectar‐like viscosity did not affect bolus velocity nor timing of swallow response and (iv) spoon‐thick viscosity reduced bolus velocity. Conclusions Resource ThickenUp Clear improves the safety of swallow without increasing residue providing a viscosity‐dependent therapeutic effect for patients with oropharyngeal dysphagia. At nectar viscosity, the effect is due to intrinsic texture properties, spoon‐thick viscosity adding changes in swallow physiology. NCT 01158313.