Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD)
Dysphagia
Newman, R., Vilardell, N., et al. (2016).
Dysphagia, 31(2), 232-249.
This systematic review examines the effect of bolus modification (e.g., thickening liquids) on swallowing in adults with oropharyngeal dysphagia.
European Society of Swallowing Disorders
Up to July 2015
Published studies (not further specified)
33
<p>In patients with oropharyngeal dysphagia, the prevalence of penetration and aspiration decreased as bolus viscosity increased from thin to nectar to pudding viscosity. Some studies showed the risk of post-swallow pharyngeal residue increased with the use of pudding thick liquids. Differences between thickening agents (e.g., xantham gum, modified starch etc.) did not have a significant effect on swallowing safety.</p><p>Additionally, several studies reported that some patients had difficulty maintaining adequate fluid intake due to aversion to thickened liquids. Limitations of this review include variability of outcome measures, lack of standardized definitions of viscosity levels, and variation in instrumental techniques. Further research in this area is warranted. </p>
