9.4.5 Thickeners for people with swallowing difficulties

Thickeners are used in the dietary management of dysphagia (swallowing difficulties) to reduce the risk of aspiration of liquids and to modify the texture of food.

Clear gum-based thickeners are now the preferred choice locally and nationally (over starch-based thickeners) as they are more palatable and safer to use.  Tins of gum-based thickener, not sachets or pre-thickened drinks, are recommended as they are more cost effective.

All patients requiring thickener should have clear guidance provided by a Speech and Language Therapist (SLT) as to which product is required and which level to thicken to.

Pre-thickened oral nutritional supplements such as other Nutilis range products and Fresubin Thickened should only be prescribed if requested by a Dietitian.

East Sussex Healthcare Trust SLTs are now recommending that the IDDSI (International Dysphagia Diet Standardisation Initiative) descriptors should be used.  More information about IDDSI can be found here:  http://iddsi.org/

For more information regarding dysphagia including advice for individual patients, and  training available for care homes, contact the following SLT teams:

  • Hastings and Rother community team: 01424 755255 ext 5236
  • Hastings and Rother stroke team: 01424 735693
  • Eastbourne, Hailsham and Seaford community team: 01323 446047
  • Eastbourne, Hailsham and Seaford stroke team: 01323 514867
  • Community Learning Disability team: 01424 726551
  • Specialist Older Peoples Mental Health Service: 01323 747224

Nutilis Clear is gluten-free and lactose-free. and is vegetarian, vegan, Halal and Kosher approved.

Review the quantity of thickener prescribed regularly to avoid waste and overprescribing:



IDDSI level 1 (slightly thick)

IDDSI level 2 (mildly thick)

IDDSI level 3 (moderately thick)

IDDSI level 4 (extremely thick)

Nutilis Clear

175g tin

At least 2 tins per month

At least 3 tins per month

At least 5 tins per month

At least 12 tins per month

175 gram
  • First Line Drugs
  • Second Line Drugs
  • Specialist Initiated Drugs with Shared Care Guidelines
  • Specialist Only Drugs
  • Mixed Status