[Dysphagia] Logemann Robbins results

[krivalcr at email.uc.edu (Kate Krival)]

Dear Sharon,

> I can't answer your question about why our patients may become dehydrated
> when on thickened liquids (my clinical impression is that they don't drink
> enough); however, I read a recent paper that suggests that fluid may not be
> unavailable even when bound by thickening agents. Here is the citation and
> abstract. The article may be accessed on the Dysphagia Journal website.
>
> Sharpe, K., Ward, L., Cichero, J. A. Y., Sopade, P., & Halley, P. (2007).
> Thickened fluids and water absorption in rats and humans. *Dysphagia,
> online first*.
> Abstract. Individuals with dysphagia are commonly provided with oral
> fluids thickened to prevent aspiration.Most thickening agents are either
> gum-based(guar or xanthan) or are derived from modified starches. There is
> evidence, predominantly anecdotal, that dysphagic individuals are
> subclinically dehydrated. Dysphagia has a particular impact on elderly
> individuals and there is justifiable concern for dehydration in this
> population. It has been speculated that dehydration may, in part, be the
> result of the waterholding capacity of these thickening agents decreasing
> water absorption from the gut. The aim of this study was to determine the
> rate of intestinal absorption of water from thickened fluids. The method
> used was a laboratory tracer study in rats and humans in vivo. We found that
> there were no significant differences in water absorption rates between
> thickened ,fluids or pure water irrespective of thickener type (modified
> maize starch, guar gum, or xanthan gum).These data provide no support for
> the view that the addition of thickening agents, irrespective of type, to
> orally ingested fluids significantly alters the absorption rate of water
> from the gut.
>
> Perhaps this will be helpful,
>
> Kate Krival M.S. CCC-SLP
> Doctoral Candidate
> Communication Sciences and Disorders
> University of Cincinnati
>
>
> On 5/9/07, Cameron, Sharon (R3) <Sharon.Cameron at rvh.nb.ca> wrote:
> >
> > As a Dietitian on the list, unfortunately I have not been privy to the
> > ASHA information.
> >
> > My question for those familiar with the research is a question about the
> > dehydration associated with thickened fluids.
> >
> > Is it a question that the fluid is bound by and therefore not available
> > to the body once thickened (more of a concern with gel thickeners) or is
> > it a question that once recommended, patients do not drink adequate
> > quantities of thickened fluids ?
> >
> > Any info greatly appreciated
> >
> >
> > Sharon Cameron
> > Registered Dietitian
> > Stan Cassidy Centre for Rehabilitation
> > 800 Priestman Street
> > Fredericton, NB  E3B 0C7
> > 506-452-5652
> >
> >