The Effects of High-Coating White Water, Low-Coating White Water, and Milk on the Identification of Swallowing Safety and Efficiency in Healthy Adults as Assessed via Flexible Endoscopic Evaluation of Swallowing: A Pilot Study.
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| Title: | The Effects of High-Coating White Water, Low-Coating White Water, and Milk on the Identification of Swallowing Safety and Efficiency in Healthy Adults as Assessed via Flexible Endoscopic Evaluation of Swallowing: A Pilot Study. |
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| Authors: | Cline, Kristen G.1,2 kgcline.slp@gmail.com, Butler, Susan G.2, Lundgren, Kristine2, Love, Kim R.3 |
| Source: | American Journal of Speech-Language Pathology. Jan2026, Vol. 35 Issue 1, p306-316. 11p. |
| Subject Terms: | *Data analysis, *Comparative studies, *Inter-observer reliability, *Adults, Pharynx physiology, Pilot projects, Research evaluation, Milk, Endoscopic surgery, Respiratory aspiration, Descriptive statistics, Chi-squared test, Odds ratio, Biomedical materials, Water, Statistics, Deglutition, Confidence intervals, Data analysis software, Deglutition disorders, Endoscopy |
| Abstract: | Purpose: The best liquid bolus protocol to use that accurately identifies penetration, aspiration, and residue on flexible endoscopic evaluation of swallowing (FEES) remains unclear. Recently, the use of high-coating white food dye–colored water has been recommended; however, evidence to support its use is limited. In this study, penetration/aspiration and residue as a function of high-coating white water, low-coating white water, and milk were systematically evaluated. Method: The effects of liquid type (i.e., high-coating white water, low-coating white water, and milk) and volume (i.e., 15, 20, and 90 ml) on penetration–aspiration scale (PAS) scores (i.e., 1–2 vs. 3–8) and residue (i.e., present vs. not present) were assessed in 20 healthy adults ages 22–53 years during FEES . Results: PAS scores, vallecular residue, and pyriform sinus residue differed significantly by liquid type (p < .001, p = .002, and p < .001, respectively). PAS scores also differed significantly by bolus volume (p = .045). In general, highcoating white water yielded a significantly greater probability of penetration events than low-coating white water and milk; however, raw PAS data revealed aspiration events (PAS 6–8) were only identified in the low-coating white water and milk conditions. Vallecular residue and pyriform sinus residue were observed in 100% of the high-coating white water swallows with markedly less residue in the low-coating white water and milk conditions. Conclusion: High-coating white water resulted in increased observed penetration events (likely due to its coating effect) compared to low-coating white water and milk while still underidentifying aspiration seen more frequently with milk test boluses in healthy adults. [ABSTRACT FROM AUTHOR] |
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| Database: | Education Research Complete |
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