Common Gastrointestinal Side Effects
Thickeners are designed to alter the viscosity of liquids, and their composition can impact the digestive system. A prominent side effect associated with Thick-It, and other starch-based thickeners, involves the gastrointestinal (GI) system.
Constipation
One of the most frequently reported side effects is constipation. This is often linked to two primary factors:
- Composition: Thick-It Original uses modified cornstarch, a high-fiber ingredient that can increase stool bulk and slow down digestion.
- Dehydration: Patients consuming thickened liquids often drink less due to altered palatability and feeling full sooner, which can lead to insufficient fluid intake and subsequently, constipation.
Gas and Bloating
Another common GI complaint is increased gas and bloating. The starch content in thickeners can be fermented by gut bacteria, leading to excess gas production. This can cause abdominal discomfort and may be more pronounced when usage begins.
Diarrhea or Loose Stools
While constipation is more common with cornstarch-based thickeners like Thick-It, some individuals may experience the opposite effect, including loose stools or diarrhea. Stool consistency can be highly individualized and depends on the patient's overall diet and fluid balance.
Potential for Dehydration
One of the most significant concerns surrounding the use of thickened liquids is the risk of dehydration. Multiple studies have demonstrated that patients on thickened fluids tend to fail to meet their daily fluid requirements.
This can happen for several reasons:
- Reduced Fluid Intake: Patients may dislike the taste and texture of thickened liquids, causing them to drink less over the course of the day.
- Early Satiety: The starch and fiber content can create a feeling of fullness more quickly, which further decreases the overall amount of fluid consumed.
- Difficulty Drinking: For some, the effort required to consume thicker liquids makes drinking tiring, especially for those with low energy or cognitive impairments.
Impact on Palatability and Quality of Life
For many patients, the unappealing taste and texture of thickened fluids present a major barrier to adherence.
Altered Taste and Texture
Thickening agents can suppress the natural flavor of a beverage and introduce an unpleasant aftertaste. The resulting texture can feel grainy, slimy, or lumpy, making the liquids less refreshing and less satisfying.
Reduced Quality of Life
Forcing individuals to consume unpleasant-tasting and textured liquids can significantly impact their quality of life. It can lead to social isolation, as it may be difficult or embarrassing for patients to mix their drinks in public settings. The frustration and dissatisfaction can contribute to poor morale and reduced enthusiasm for eating and drinking.
Decreased Medication Effectiveness
Thickened liquids can potentially impact the bioavailability and effectiveness of orally administered medications. The altered viscosity can change how quickly a medication is absorbed by the body, potentially delaying its onset or reducing its overall effect. This is a critical consideration and should always be discussed with a healthcare provider and pharmacist.
Special Considerations for Specific Populations
Infants and Young Children
Thick-It products carry a specific warning from the manufacturer regarding their use in infants and young children. Kent Precision Foods Group, the maker of Thick-It, recommends that their products not be used for infants under 2 years old and only be used for children under 12 in consultation with a physician. This caution stems from general concerns about thickeners in infants, with separate, more severe warnings for xanthan gum-based thickeners like SimplyThick due to a link with necrotizing enterocolitis (NEC).
Managing Side Effects
To mitigate some of the adverse effects of thickeners, healthcare providers may recommend several strategies:
- Adjusting Consistency: Finding the lowest effective level of thickening can help improve taste and intake without compromising swallowing safety.
- Monitoring Hydration: Actively tracking a patient's fluid intake and output can help prevent dehydration. In some cases, a physician may recommend supplemental hydration methods.
- Dietary Changes: Adding high-fiber foods to the diet and ensuring proper fluid intake from other sources (like high-moisture fruits and vegetables) can help with constipation.
- Alternative Thickeners: Discussing other types of thickeners with a speech-language pathologist (SLP) or physician may be beneficial if a patient is experiencing severe side effects with a specific product.
Comparison Table: Thick-It vs. Xanthan Gum Thickeners
To illustrate the differences between common thickener types, here is a comparison based on known side effects and properties.
| Feature | Thick-It (Starch-Based) | Xanthan Gum Thickeners (e.g., SimplyThick) |
|---|---|---|
| Primary Side Effects | Constipation, gas, bloating, dehydration risk | Diarrhea, gas, bloating, dehydration risk |
| Primary Ingredient | Modified cornstarch | Xanthan gum |
| Texture Profile | Can feel grainy or slightly chalky | Generally smoother, clearer consistency |
| Shelf Life/Stability | Can continue to thicken over time | More stable viscosity over time |
| Infant Use Warning | Not recommended for infants under 2; use caution in children under 12 | Specific FDA warnings and higher NEC risk concerns, especially for premature infants |
| Impact on Taste | Can suppress natural flavor and leave an aftertaste | Generally less impact on taste and appearance |
Conclusion
While Thick-It is an essential tool for managing dysphagia and preventing aspiration, it is not without potential drawbacks. Patients and caregivers should be vigilant for side effects such as gastrointestinal distress, dehydration, and reduced fluid intake due to altered palatability. Always consult with a healthcare professional, including a physician and a speech-language pathologist, to determine the appropriate thickener type and consistency. Monitoring for adverse effects and adjusting management strategies as needed is key to ensuring both safety and quality of life for the individual. The risks must be carefully weighed against the benefits of preventing aspiration.
