The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia

Thickened fluids are commonly prescribed for the medical management of individuals who have swallowing difficulty. However, it is not always easy to obtain the prescribed thickness consistency of thickened fluids and, a common contributor to variabilities in thickness consistency is the type of thic...

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Autores principales: Enrico K. Hadde, Brenda Mossel, Jianshe Chen, Sangeeta Prakash
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Lenguaje:EN
Publicado: Elsevier 2021
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Acceso en línea:https://doaj.org/article/6c66e46fb37c47d3bbbd345d23c5b5d5
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spelling oai:doaj.org-article:6c66e46fb37c47d3bbbd345d23c5b5d52021-11-28T04:39:42ZThe safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia2667-025910.1016/j.fhfh.2021.100038https://doaj.org/article/6c66e46fb37c47d3bbbd345d23c5b5d52021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667025921000303https://doaj.org/toc/2667-0259Thickened fluids are commonly prescribed for the medical management of individuals who have swallowing difficulty. However, it is not always easy to obtain the prescribed thickness consistency of thickened fluids and, a common contributor to variabilities in thickness consistency is the type of thickener selected. Xanthan gum-based thickeners are increasingly used in commercial thickening products for management of oropharyngeal dysphagia (OD). While less common, xanthan gum-based thickening agent in a liquid form is an alternative thickening agent for use only under medical supervision for the management of OD. It is hypothesised that liquid thickener is substantially equivalent in safety and therapeutic function to xanthan gum-based powdered thickener. This systematic review aims to identify the safety and efficacy of powdered and liquid xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of OD. A multi-engine search yielded 210 non-duplicate articles of which 43 were judged to be relevant. The articles underwent detailed review for study quality and data extraction that confirmed xanthan gum-based thickened fluids are effective in improving the safety of swallow and reduce aspiration without increasing the prevalence of pharyngeal residue. Additionally, xanthan gum-based thickeners are superior to starch-based because of better texture perception, more cohesive, better stability (e.g., time or temperature) and better resistance to salivary amylase. Both forms (liquid or powder) of thickener are clinically safe and effective in improving the swallow safety in individuals with OD, although published clinical data supporting the safety and efficacy of liquid xanthan gum is more limited. However, in some situations, liquid form is more suitable than powdered alternatives because it is more readily dissolves directly in the fluid, although to date, there are no published clinical trials supporting the safety and efficacy of liquid xanthan gum.Enrico K. HaddeBrenda MosselJianshe ChenSangeeta PrakashElsevierarticleDysphagiaXanthan gumThickened fluidsLiquid thickenerNutrition. Foods and food supplyTX341-641Nutritional diseases. Deficiency diseasesRC620-627ENFood Hydrocolloids for Health, Vol 1, Iss , Pp 100038- (2021)
institution DOAJ
collection DOAJ
language EN
topic Dysphagia
Xanthan gum
Thickened fluids
Liquid thickener
Nutrition. Foods and food supply
TX341-641
Nutritional diseases. Deficiency diseases
RC620-627
spellingShingle Dysphagia
Xanthan gum
Thickened fluids
Liquid thickener
Nutrition. Foods and food supply
TX341-641
Nutritional diseases. Deficiency diseases
RC620-627
Enrico K. Hadde
Brenda Mossel
Jianshe Chen
Sangeeta Prakash
The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
description Thickened fluids are commonly prescribed for the medical management of individuals who have swallowing difficulty. However, it is not always easy to obtain the prescribed thickness consistency of thickened fluids and, a common contributor to variabilities in thickness consistency is the type of thickener selected. Xanthan gum-based thickeners are increasingly used in commercial thickening products for management of oropharyngeal dysphagia (OD). While less common, xanthan gum-based thickening agent in a liquid form is an alternative thickening agent for use only under medical supervision for the management of OD. It is hypothesised that liquid thickener is substantially equivalent in safety and therapeutic function to xanthan gum-based powdered thickener. This systematic review aims to identify the safety and efficacy of powdered and liquid xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of OD. A multi-engine search yielded 210 non-duplicate articles of which 43 were judged to be relevant. The articles underwent detailed review for study quality and data extraction that confirmed xanthan gum-based thickened fluids are effective in improving the safety of swallow and reduce aspiration without increasing the prevalence of pharyngeal residue. Additionally, xanthan gum-based thickeners are superior to starch-based because of better texture perception, more cohesive, better stability (e.g., time or temperature) and better resistance to salivary amylase. Both forms (liquid or powder) of thickener are clinically safe and effective in improving the swallow safety in individuals with OD, although published clinical data supporting the safety and efficacy of liquid xanthan gum is more limited. However, in some situations, liquid form is more suitable than powdered alternatives because it is more readily dissolves directly in the fluid, although to date, there are no published clinical trials supporting the safety and efficacy of liquid xanthan gum.
format article
author Enrico K. Hadde
Brenda Mossel
Jianshe Chen
Sangeeta Prakash
author_facet Enrico K. Hadde
Brenda Mossel
Jianshe Chen
Sangeeta Prakash
author_sort Enrico K. Hadde
title The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
title_short The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
title_full The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
title_fullStr The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
title_full_unstemmed The safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
title_sort safety and efficacy of xanthan gum-based thickeners and their effect in modifying bolus rheology in the therapeutic medical management of dysphagia
publisher Elsevier
publishDate 2021
url https://doaj.org/article/6c66e46fb37c47d3bbbd345d23c5b5d5
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