“Thick water” refers to water altered to flow more slowly than its natural state, typically by adding a commercial thickening agent. This modification is a common strategy used in the management of dysphagia, the medical term for difficulty swallowing. Preparing thickened liquids at home requires careful attention to the type of thickener and the mixing technique. The purpose is to provide hydration while minimizing the risk of complications associated with swallowing thin liquids.
Why Thicken Liquids Are Necessary
Difficulty swallowing (dysphagia) often makes consuming thin liquids hazardous. Thin liquids, such as plain water, flow quickly, making them difficult to control in the mouth and throat. This rapid movement can lead to the liquid entering the airway, a serious condition known as aspiration.
Aspiration occurs when fluid enters the lungs, potentially causing choking or a severe lung infection called aspiration pneumonia. Thickened liquids move more slowly, which gives the individual more time to coordinate the swallow reflex and protect the airway. Slowing the fluid’s transit time allows the body a better opportunity to close the airway before the liquid passes into the esophagus.
Choosing the Right Thickening Agent
Commercial thickening agents fall into two categories: starch-based and gum-based. Starch-based thickeners, typically made from modified cornstarch, absorb water to create viscosity. However, these thickeners are susceptible to the enzyme amylase found in saliva. This means the thickened liquid can begin to thin out in the mouth during consumption.
Gum-based thickeners, most often utilizing xanthan gum, create a more stable viscosity not affected by amylase. This stability ensures the liquid maintains its prescribed thickness from the cup to the throat. Xanthan gum-based products are also often calorie-free and can be heated, frozen, and thawed without significant changes to their viscosity.
Step-by-Step Preparation Methods
Successfully preparing thickened water relies on accurate measurement and a specific mixing technique. Ratios can vary between different brands and types of thickeners, so always consult the product label and instructions from a healthcare professional. The required amount of powder is typically measured using the scoop provided in the container, which is calibrated for that specific product.
Start by placing the measured amount of powder into a clean, dry cup before adding the liquid to prevent clumping. Gradually pour the water over the powder while immediately stirring briskly for about 15 to 30 seconds. A vigorous stirring motion helps the powder dissolve completely and prevents the formation of lumps. After mixing, the thickened water must stand for a specific period, usually between one and five minutes, to reach its final consistency.
Ensuring Safe Consistency and Storage
The final step is confirming the liquid has reached the correct, prescribed consistency, which should never be self-determined. A speech-language pathologist evaluates swallowing function and specifies the exact thickness level required for safety. The International Dysphagia Diet Standardization Initiative (IDDSI) provides a global framework for describing these consistencies, using levels like Mildly Thick or Moderately Thick.
To objectively check the final product, the IDDSI Flow Test is the standard home method. This test uses a 10-milliliter slip-tip syringe and a 10-second timer to measure how much liquid flows out. Once mixed, thickened water should be covered and refrigerated. It must generally be consumed or discarded within 24 to 72 hours to ensure safety and prevent bacterial build-up.