Effect of a gum-based thickener on the safety of swallowing in patients with poststroke oropharyngeal dysphagia

Background Increasing viscosity with thickening agents is a valid therapeutic strategy for oropharyngeal dysphagia (OD). To assess the therapeutic effect of a xanthan gum‐based thickener (Nutilis Clear®) at six viscosities compared with thin liquid in poststroke OD (PSOD) patients. Methods A total of 120 patients with PSOD were studied in this controlled, multiple‐dose, fixed‐order, and single‐blind study using videofluoroscopy (VFSS). A series of boluses of 10 mL thin liquid and 2000, 1400, 800, 450, 250, and 150 mPa s viscosities were given in duplicate, interrupted in case of aspiration. We assessed the safety and efficacy of swallow and the kinematics of the swallow response. Key Results A total of 41.2% patients had safe swallow at thin liquid which significantly increased for all viscosities from 71.9% at 150 mPa s to 95.6% at 1400 mPa s (P
This study shows a strong therapeutic effect of a gum‐based thickener on safety of swallow in post‐stroke dysphagia that depends on shear viscosity levels, and a therapeutic range of 150‐800 mPa s. Increasing viscosity shortened time to laryngeal vestibule closure at all viscosities and reduced bolus velocity at ≥450 mPa s.