Dysphagia is a potentially life-threatening symptom of several neurological conditions, including strokes, dementia, and head injuries. It causes patients to have problems swallowing and often causes coughing, choking, and a sensation of having food stuck in the throat. In some cases, speech therapy can help patients with dysphagia learn new swallowing techniques, but most also have to make adjustments to their diets such as using thickeners when drinking liquids.
There are two types of thickeners: starch-based and gum-based. Patients and their caregivers should know that not all thickeners are created equal, though. Read on to find out about the difference between starch-based and gum-based varieties for help with choosing the right one or learn more from johnlholahan.com before purchasing new products.
Starch-based thickeners use modified cornstarch, which contains a lot of amylopectins. This insoluble component turns liquids into gels, not solids, to build viscosity and make them easier to swallow. It’s important to note that modified cornstarch does not become fully hydrated for several hours after mixing, though, so drinks prepared with this kind of thickener must be made well in advance.
Gum-based thickeners are made with clarified xanthan gum, a polysaccharide that also turns liquids into gels. Instead of amylopectin, it contains the sugars galactose and mannose, two types of cellulose that can absorb liquids much faster. That means there’s no need to wait for multiple hours before consuming drinks thickened with xanthan gum.
Consistency When Mixed
Starch-based thickening products are less stable than gum-based thickeners. They are more susceptible to changes in heat and less able to withstand acidic conditions like those induced by mixing with many juices. Starch thickeners cannot be frozen, as thawing causes separation from the liquid. Gum-based thickeners are less susceptible to temperature changes and acidic conditions and can maintain their consistency after freezing and thawing.
Consistency During Consumption
Gum-based thickeners are also better able to maintain their consistency in consumers’ mouths thanks to the use of cellulose instead of amylopectin as a thickening agent. Amylopectin tends to break down when exposed to human saliva because it contains the enzyme amylase. This causes thinning of the beverage over time, which can be especially problematic given that dysphagia patients typically take more time to eat and drink than normal.
Unlike starch-based thickeners, gum-based thickeners do not break down when exposed to amylase. That means they won’t separate in consumers’ mouths. This substantially reduces the risk of aspiration.
Taste and Texture
Starch-based products tend to create a cloudy appearance in clear liquids, add a grainy texture, and may alter their tastes. This can be problematic for dysphagia patients who already struggle to stay hydrated.
Gum-based products, on the other hand, are more appetizing. They have a smooth texture, do not cause clouding in clear liquids, and generally don’t have any taste at all, which can make drinks much more appealing. Plus, dysphagia patients or their caregivers must use less of gum-based thickeners to achieve the same results.
The Bottom Line
It used to be the case that starch-based thickeners were the only option for dysphagia patients who wanted to avoid aspiration and its associated complications. Today, gum-based thickeners provide a better alternative. Just make sure to purchase high-quality products from trustworthy companies and read through a few consumer reviews before choosing which one to use.