Path to Dysphagia Diagnosis
  • Carinda Stout, MS CCC/SLP

Thickened Liquids & Dehydration: A Closer Look

The first concern with maintaining hydration with thickened liquids is whether the water present in the thickened liquid will be available for release into the patient’s system as usable hydration.


If a significant portion of the water remains bound to the molecules of thickener and passes through the system, then the patient will be required to drink greater amounts of thickened liquid to achieve hydration goals. Sharpe et al. (2007) reported that all the starch- and gum-based thickeners tested in rats and humans released 95+% of the fluid content to the subject’s systems. Therefore, the use of thickened liquids will not contribute to patient dehydration.


Thickened liquids will not contribute to patient dehydration

The second concern is the amount of a thickened liquid consumed by the patient, which is heavily dependent on the patient liking the thickened liquid(s). Corn starch and food starch are the most common used to thicken liquids. They are marketed in a dry granular form are mixed with liquids at specific ratios to produce a desired viscosity. Likeability also depends on the amount of thickener in the mixture. Whelan (2001) reported that patients will consume more of a thinner, nectar-thickened liquid than a more viscous product. When a starch-base is used, these more viscous thickened liquids have more starch and less flavor (Huckabee & Pelletier, 1999). As the amount of starch increases, the amount of “flavor masking” increases and likeability decreases. As likeability decreases so may consumption, which may increase the risk for dehydration.





Lastly, the mixing characteristics of granular starch-based products can be problematic. When mixed with liquid, the granules may not hydrate uniformly, resulting in a thickened liquid that contains lumps and clumps. This texture may negatively affect a patient’s desire to consume the product.