Cichero Julie A Y
Nutr J. 2013 May 1;12:54. doi: 10.1186/1475-2891-12-54.
Dysphagia is the medical term for difficulty swallowing. Thickened liquids are often used in the management of dysphagia to improve bolus control and to help prevent aspiration. A range of starches and gums has historically been used to thicken liquids. Although thickened liquids improve swallow safety, they appear to have a great potential for unintended physiological consequences. Initial concerns were raised about the impact of thickeners on water binding due to the high prevalence of dehydration amongst individuals with dysphagia. Thankfully, regardless of thickening agent, thickeners do not affect water bioavailability. This effect holds true even for extremely thick fluids. However, bioavailability of medication is impaired with viscous substances. Liquids thickened to as little as 150 mPa.s retards drug release. In addition, feelings of satiety and thirst increase with increasingly viscous fluids. Flavour deteriorates with increasing thickness regardless of thickening agent. Therapeutically clinicians often prescribe small volumes of thickened liquids, consumed often. Yet small volumes of thick substances consumed with a long oral processing time, which is common for individuals with dysphagia, reduces the amount consumed. A combination of poor flavour, and increasing feelings of fullness result in little motivation and poor physiologic drive to consume thickened liquids.
吞咽困难是指吞咽困难的医学术语。增稠液体常用于吞咽困难的管理，以改善食团控制并帮助防止误吸。历史上，一系列淀粉和树胶被用于增稠液体。尽管增稠液体提高了吞咽安全性，但它们似乎有很大的潜在意外生理后果。最初人们担心增稠剂对水结合的影响，因为吞咽困难患者中脱水的患病率很高。幸运的是，无论增稠剂如何，增稠剂都不会影响水的生物利用度。即使对于极稠的液体，这种效果也成立。然而，粘性物质会损害药物的生物利用度。增稠至仅150毫帕·秒的液体就会延迟药物释放。此外，随着液体粘度的增加，饱腹感和口渴感也会增加。无论增稠剂如何，随着厚度增加，味道都会变差。在治疗上，临床医生通常会开少量的增稠液体，且经常服用。然而，对于吞咽困难患者来说，少量的浓稠物质在长时间口腔处理过程中被消耗，这会减少摄入量。味道不佳和饱腹感增加的综合作用导致摄入增稠液体的动力不足和生理驱动力不佳。
