Swallowing Solutions Newsletter January 2026
Thickened Liquids & Swallowing Safety
Understanding Options, Benefits, and Considerations
Difficulty swallowing liquids (dysphagia) is common with aging, neurological conditions, stroke, Parkinson’s disease, and other medical changes. When liquids move too quickly, they can enter the airway instead of the esophagus, increasing the risk of coughing, choking, or aspiration.
Thickened liquids are used to slow the flow of liquids, giving the swallowing muscles more time to coordinate a safe swallow. Thickening is a clinical tool, not a one-size-fits-all solution, and should always be guided by a swallowing professional.
Levels of Liquid Thickness
Liquids may be modified to different consistencies based on individual swallowing needs:
Thin (water, coffee)
Slightly thick / Nectar-thick
Moderately thick / Honey-thick
Extremely thick / Pudding-thick
The appropriate level is determined through a clinical swallow evaluation and, when needed, instrumental testing.
Types of Thickeners
1. Starch-Based Thickeners
These are traditional powder thickeners made from modified starch.
Examples include:
Thick‑It
Resource ThickenUp (classic versions)
Benefits
Widely available
Lower cost
Familiar to many caregivers
Considerations
Continue thickening over time
Texture may feel grainy
Can break down with saliva
Less stable in hot or acidic liquids
2. Gum-Based Thickeners (Xanthan or Guar Gum)
These provide more consistent thickness and clearer liquids.
Examples include:
SimplyThick
ThickenUp Clear
Clear DysphagiAide
Benefits
Stable over time
Smooth texture
Work well in hot and cold liquids
Often clearer and more palatable
Considerations
Higher cost
Not appropriate for all medical populations
Some individuals experience gastrointestinal sensitivity
3. Food-Based Thickening Options
Some foods naturally provide thickness.
Examples
Yogurt
Applesauce
Smoothies
Puréed fruits or soups
Benefits
Often better accepted
Adds nutrition and calories
More natural option
Considerations
Thickness can vary by brand or preparation
Must still match prescribed consistency
Should be guided by a swallowing professional
Benefits of Thickened Liquids
Improved swallow safety
Reduced aspiration risk
Greater swallow control
Increased confidence during meals
Potential Risks & Cautions
Reduced fluid intake
Dehydration
Constipation
Dislike of texture or taste
Over-thickening without guidance
Important:
Thickening liquids is not always permanent and should be reassessed regularly.
Common Myths
“Thicker is always safer” — Not true
“Once thickened, always thickened” — Not always
“Everyone who coughs needs thickener” — Evaluation matters
When to Reassess Swallowing
Changes in health or medications
Increased coughing or choking
Weight loss or dehydration
Recurrent respiratory infections
Avoidance of drinking
Final Takeaway
Thickened liquids can be a valuable tool in swallowing safety when used appropriately and monitored carefully. The goal is always to support safe, comfortable, and enjoyable eating and drinking while maintaining hydration and quality of life.