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Having Difficulty Swallowing? Learn About Dysphagia

Beverage thickener Choking Dysphagia Swallowing Problems Thicken Food Xanthan Gum

Woman with Dysphagia Eating soup


Dysphagia is a medical term for the difficulty or inability to swallow safely and efficiently.

The swallowing process is made up of 4 phases — the first phase starts with your lips and the last phase ends when food enters your stomach. Swallowing dysfunction along any point from your mouth to your throat (phases 1 to 3) can result in food and liquids entering the “wrong tube” and into your airway. This is known as oropharyngeal dysphagia (or simply dysphagia).


Conditions that may cause dysphagia include:

  • Stroke
  • Progressive neurologic diseases, such as Parkinson’s, Multiple Sclerosis, ALS or Alzheimer’s disease
  • Cerebral palsy
  • Brain injury or tumors
  • Head and neck cancer
  • Injury or surgery to the head and/or neck


  • Difficulty swallowing foods, liquids or saliva
  • Frequent coughing or choking before or after swallowing
  • Drooling
  • A need to swallow repeatedly
  • A “wet” or gurgly voice, especially after swallowing
  • Unintended weight loss
  • Feel like you have a lump in your throat
  • Food that gets stuck in your cheeks or the roof of your mouth

If you or someone you care for has experienced any of these symptoms, speak with a healthcare professional.


Poor nutrition and dehydration:

Because weak throat muscles can make eating and drinking challenging, some
people skip meals or avoid drinking beverages. This could result in the inability to consume enough foods and/or liquids to maintain proper nutrition and hydration.

Aspiration pneumonia or chronic lung disease:

Muscles in the throat typically block food and saliva from entering the airway and lungs. But as muscles weaken, food might go down the “wrong way” — into the lungs instead of the stomach and may lead to pneumonia.


First you must talk to your healthcare professional regarding your swallowing difficulties so that they can properly diagnose your condition. If you’ve been diagnosed with dysphagia, you will be given a customized plan that may include exercises to improve swallowing function and a modified diet to make eating and drinking more manageable.

Types of food that may require modification:

Some foods are more difficult for people with dysphagia to swallow, such as:

  • Foods that require a lot of chewing
  • Foods that have many small particles, like seeds
  • Dry and/or crumbly foods
  • Foods that combine liquids and solids
  • Thin liquids such as water and juice
  • Foods that become liquid in your mouth, such as ice cream

Ways to modify food and beverages:

With these types of modifications, swallowing can be much safer and more comfortable, and help assure you get the nutrition and hydration you need to maintain your health.

  • Thickening your drinks to a more manageable consistency, reducing your chance of unsafe swallowing
  • Pureeing your food to make it easier to swallow
  • Adding moistening agents, such as gravy, to your food

Dysphagia Food

Based on your condition and the standards set by the National Dysphagia Diet, your healthcare professional will be able to create your diet modification plan, including which liquid and solid food consistencies are right for you. Use this consistency guide to help assure your food and beverages are the proper consistency.

Liquid Consistencies:

  • Thin: All beverages are acceptable (no modifications required)
  • Nectar-like: The beverage coats and drips off a spoon, similar to unset gelatin
  • Honey-like: The liquid is thicker than “nectar-like” and flows off a spoon in a ribbon, just like actual honey
  • Pudding-like: Liquid stays on the spoon in a soft mass and “plops” off the spoon like pudding

Solid Food Consistencies:

  • Regular diet (Level 4): All foods are acceptable
  • Dysphagia advanced (Level 3): Most foods are acceptable with the exception of hard, crunchy, stringy or sticky foods
  • Dysphagia mechanically altered (Level 2): All food should be moist and easily mashed with a fork — meats can be ground or chopped into 1/4’’ pieces or smaller; vegetables should be well cooked and easy to chew
  • Dysphagia pureed (Level 1) — All solid foods should be pureed to a smooth cohesive texture without lumps


There are many beverage thickening options available:

Starch-based thickeners present many challenges and are not recommended.  They alter the appearance and taste of beverages, do not maintain their consistency over time (they continue to thicken and separate), and are complicated to mix.

Xanthan gum thickeners are far superior to starch thickeners.  They are tasteless, odorless, clump-free and mix easily into hot or cold beverages.  The consistency of the food or beverage stays stable so you can be assured that it will remain at the right level of thickness to prevent choking.  Xanthan gum thickeners add few (if any) calories and are gluten free. Read about the advantages of Xanthan Gum thickeners.

Carob-bean thickeners have all natural ingredients and are considered safe for infants who need their formula or breast milk thickened.


Buy online from Caring Solutions in Canada.

Simplythick and ThickenUp Clear are two of the leading xanthan gum thickeners available in Canada.  If you or your loved one are suffering from dysphagia and want to maximize enjoyment of the thickened food and beverages that are now required, then these thickeners are truly the superior choice.  

SimplyThick food and beverage thickenerThickUp Clear Powder Thickener

Gelmix is a natural thickening powder that uses organic carob bean gum as the thickenering agent.  It is the first and only USDA certified organic thickener specifically formulated for pediatric use in America, and is considered safe for infants over 42 weeks gestational age.

Gelmix powder thickener and scoopGelmix thickener stick packs


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