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Thickened fluids are commonly used in the medical management of individuals who suffer swallowing difficulty (known as dysphagia). Previous studies have shown that the rheological properties of a liquid affect the flow behavior of the bolus in swallowing, such as pharyngeal transit time. While there is no doubt that shear rheology is a highly important factor for bolus flow, it is suspected that extensional properties of a liquid bolus also plays an important role in swallowing, due to elongation of the bolus as it flows through the oropharynx. Our aim in this work was to observe the effect of extensional viscosity on pharyngeal transit time and elongation of the bolus during swallowing. Eight samples of thickened liquid barium that were shear-controlled, but varied in extensional viscosity and two samples that were extensional-controlled, but varied in shear viscosity were swallowed by eight healthy individuals. Data were collected under lateral view of videofluoroscopy swallow study (VFSS); measures of pharyngeal transit time and the ratio of the length to the width of the bolus on the frame of Upper Esophageal Sphincter (UES) opening were taken from the VFSS recordings. It was observed that the pharyngeal transit time generally increases when the fluids are thickened to higher IDDSI consistency. Additionally, higher extensional viscosity fluids reduced the elongation of the bolus during swallowing, thus potentially reducing the risk of post-swallow residue due to bolus breakage. This study confirmed the relevance of the extensional viscosity of the bolus in swallowing.

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Thickened fluids and texture‐modified foods are commonly used in the medical management of individuals who suffer from swallowing difficulty (known as dysphagia). However, how to reliably assess texture properties of such food systems is still a big challenge both to industry and to academic researchers. This article aims to identify key physical parameters that are important for objective assessment of such properties by reviewing the significance of rheological or textural properties of thickened fluids and texture‐modified foods for swallowing. Literature reviews have identified that dominating textural properties in relation to swallowing could be very different for thickened fluids and for texture‐modified foods. Important parameters of thickened fluids are generally related with the flow of the bolus in the pharyngeal stage, while important parameters of texture‐modified foods are generally related with the bolus preparation in the oral stage as well as the bolus flow in the pharyngeal stage. This review helps to identify key textural parameters of thickened fluids and texture‐modified foods in relation to eating and swallowing and to develop objective measuring techniques for quality control of thickened fluids and texture‐modified foods for dysphagia management.

Purpose – The purpose of this paper was to examine the rheological characterisation of thickened water under different temperature and pH conditions and thickened milk with different fat contents. Design/methodology/approach – Beverages thickened with powdered thickeners are used in the medical management of individuals who suffer swallowing difficulties (dysphagia). Each individual requires a specific level of thickness to best meet the needs of their dysphagia. Although the level of thickness is defined, obtaining the correct consistency of thickened fluids is difficult. This is due to fluctuations associated with temperature and type of fluids to be thickened. Rheological characterisation of commercially available xanthan gum-based thickener was performed under different conditions of temperature, pH and fat contents. Findings – The viscosity and the yield stress of thickened water was found to be unaffected by pH. Similarly, temperature did not affect the viscosity at a high thickener concentration, although it did at lower concentration levels. Conversely, viscosity and yield stress increased as fat levels increased in thickened milk. Furthermore, thickened water took less than 2 minutes to reach equilibrium viscosity, while thickened milk required approximately 15 minutes to reach equilibrium viscosity. Practical implications – These findings have implications for the standing time required for different beverages before they are thickened to a consistency that has been deemed safe for the patient’s physiological needs. Additionally, it highlights that different liquid base substances required different amounts of thickener to achieve the same level of thickness. Originality/value – Findings from this study confirms and explores the variability of thickened fluids under different conditions of temperature, pH and fat content for the medical management of dysphagia.

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