Should I Drink Thickened Liquids?
You or a family member might find yourself back at home after being discharged from a hospital stay. Following an unexpected medical issue, you discovered difficulty swallowing, known as dysphagia. During your hospital stay, you received advice on managing this issue, such as consuming thickened liquids to prevent choking. Now that you're home, you might be wondering if you should continue with this recommendation.
While I cannot provide medical advice, let me shed light on thickened liquids, their purpose, and the advantages vs disadvantages of consuming them when you have adult dysphagia. For personalized guidance, I suggest consulting your doctor and an outpatient speech pathologist to assist you in managing dysphagia at home.
Understanding Thickened Liquids
Thickened liquids refer to beverages like water or juice that have been altered by adding a thickening agent to increase viscosity. These agents can be purchased without a prescription and are readily available over the counter. Various companies produce thickening agents, which can be either starch-based (e.g., cornstarch, tapioca starch) or gum-based (e.g., xanthan gum in gel form or powder). It's essential to note that there are different levels of thickness:
Thin liquids (no thickener, the usual beverage consistency)
Slightly thickened (similar to drink/nutritional supplements)
Mildly thickened (similar to nectar juices)
Moderately thickened (resembling honey)
Extremely thick (resembling pudding; honestly, I do not consider this level a liquid)
The Advantages of Drinking Thickened Liquids
There are various types of dysphagia that require different approaches. For individuals struggling with swallowing thin liquids and experiencing them entering the airway, thickened liquids can be beneficial. This is because thickened liquids move more slowly in the throat, giving the swallowing muscles more time to react and hopefully reducing aspiration. The goal is to prevent liquids from entering the airway, thus lowering the risk of aspiration-related pneumonia.
Alternatively, individuals with oral dysphagia, where they struggle to manage liquids or food in the mouth, may find it easier to control thickened drinks. Compared to thin liquids that may leak from the lips or go down the throat too quickly, they might be able to handle a sip of thickened liquids with more control. This could reduce embarrassment of drinking in front of others, worrying whether you’ll drool or not.
Risks Associated with Drinking Thickened Liquids
While thickened liquids are often seen as beneficial, they do come with potential risks. Here are some important points to consider:
Some thickening agents can affect the breakdown of pills, although not all medications are affected. Research indicates that certain tablets may take longer to break down when mixed with thickened drinks.
Dehydration and urinary tract infections (UTIs) are also concerns. Thickened liquids themselves don't directly cause dehydration or UTIs; rather, the issue lies in reduced fluid intake. People consuming thickened liquids tend to drink less, which can lead to dehydration and associated complications.
Difficulty in clearing thickened fluids poses another risk. When swallowing or coughing abilities are compromised, pockets in the throat can retain food and liquids. Dysphagia makes it challenging to clear thick liquids from these areas of the throat.
Are there other options besides drinking thickened liquids?
Some individuals might discover that consuming thickened liquids is more enjoyable when opting for naturally thicker beverages rather than relying on a thickening agent. For instance, nectar juices, fruit smoothies, milkshakes, and similar drinks are naturally thicker than water. Alternatively, others may choose to follow a "free water protocol" (more details on that in a separate post). In a free water protocol, water is not thickened but all other beverages are thickened. Lastly, others may decide against modifying their beverages and, instead, utilize specific postures, techniques, and drinking vessels to help them consume regular, thin liquids more safely.
Should I Continue Drinking Thickened Liquids?
By this point, you might realize that the decision to consume thickened liquids can be quite complex. Opting for thickened liquids temporarily could be beneficial for individuals with dysphagia while undergoing swallowing therapy to enhance their swallowing abilities. However, there might be more effective strategies to manage dysphagia for other people. It's important to note that this blog does not provide medical advice but aims to offer general, educational information. I highly recommend reaching out to a speech pathologist today to develop a personalized treatment plan that is right for you!
