Abstract
Introduction: The present study explored the ways to prepare thickened liquids of different consistencies using lotus root starch (LRS) powder and evaluated their efficacy in treating poststroke dysphagic patients. Methods: Thickened liquids matching the four consistency levels advocated by the International Dysphagia Diet Standardization Initiative (IDDSI) guidelines were prepared. To assess their clinical applicability, 76 poststroke dysphagic patients were randomly divided into three groups: xanthan gum (XG) group (n = 26), LRS group (n = 26), and control group (n = 24). All groups received an intervention including swallow-related exercises and oral feeding training. The control group used regular foods (water, juice, congee, egg custard, and banana puree), while the XG and LRS groups used their respective thickened liquids. Swallowing performance was assessed before and after the intervention using the Standardized Swallowing Assessment (SSA) and the Penetration-Aspiration Scale (PAS). In addition, data on gastric tube use duration, removal rate, incidence of adverse reactions, and the cost of thickening associated with the three groups were collected after the intervention. Results: While all groups experienced a significant improvement after the intervention, as indicated by the SSA and PAS scores, the XG and LRS groups demonstrated significantly better outcomes than the control group. In addition, the XG and LRS patients had shorter gastric tube use, greater removal rate, and fewer incidence of adverse reactions than the controls. The cost of XG was greater than that of LRS powder for the intervention. Conclusion: LRS powder can be used to prepare thickened liquids of different consistencies following the IDDSI framework. Its efficacy and safety in treating dysphagia are comparable to XG-based thickeners. However, seeing its markedly lower cost, LRS powder can be considered a viable alternative to XG-based commercial thickeners.
Plain Language Summary
The present study explored the use of lotus root starch (LRS) powder as a natural, low-cost thickener for liquids to help stroke patients with swallowing difficulties (dysphagia). Swallowing of LRS-thickened liquids was compared to that of a common synthetic thickener (xanthan gum or XG) and regular foods including water, juice, porridge, and pureed banana. All patients carried out swallowing exercises and feeding training for 3 weeks, and swallowing ability was assessed before and after the training. Results showed that both LRS and XG thickened liquids improved swallowing safety and reduced feeding tube use more than regular foods. LRS was just as effective as XG but much cheaper, making it a great alternative. Few side effects were reported. The study highlights LRS as a safe, affordable, and natural option for dysphagia management, offering a practical solution for stroke patients struggling with swallowing.
