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PEG and Thickeners: A Critical Interaction Between Polyethylene Glycol Laxative and Starch-Based Thickeners.

Authors
  • Carlisle, Brian J1
  • Craft, Garrett2
  • Harmon, Julie P2
  • Ilkevitch, Alina3
  • Nicoghosian, Jenik3
  • Sheyner, Inna4
  • Stewart, Jonathan T4
  • 1 University of South Florida College of Medicine, Tampa, FL. Electronic address: [email protected]
  • 2 University of South Florida College of Arts and Sciences, Tampa, FL.
  • 3 James A. Haley VA Hospital, Tampa, FL.
  • 4 University of South Florida College of Medicine, Tampa, FL; James A. Haley VA Hospital, Tampa, FL.
Type
Published Article
Journal
Journal of the American Medical Directors Association
Publication Date
Sep 01, 2016
Volume
17
Issue
9
Pages
860–861
Identifiers
DOI: 10.1016/j.jamda.2016.06.024
PMID: 27569713
Source
Medline
Keywords
License
Unknown

Abstract

Clinicians commonly encounter dysphagia and constipation in a skilled nursing population. Increasing the viscosity of liquids, usually with a starch- or xanthan gum-based thickener, serves as a key intervention for patients with dysphagia. We report a newly identified and potentially dangerous interaction between polyethylene glycol 3350 laxative (PEG) and starch-thickened liquids. A patient requiring nectar-thickened liquids became constipated, and medical staff prescribed PEG for constipation. His nurse observed that the thickened apple juice immediately thinned to near-water consistency when PEG was added. She obtained the same results with thickened water and coffee. We quantified this phenomenon by isothermal rotational rheology. Results confirmed a precipitous loss of thickening when PEG was added to starch-based thickeners but not with xanthan gum-based thickeners. Clinicians and front-line staff should be aware of this potentially critical interaction between PEG- and starch-based thickeners. Although confirmatory studies are needed, our preliminary data suggest that PEG may be compatible with xanthan gum-- based thickeners.

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