Effects of barium sulfate on rheological properties and IDDSI flow consistency of liquid stimuli prepared using commercial thickening powders.

During videofluoroscopic swallowing study (VFSS), barium sulfate (BaSO 4 ) is commonly added into food samples as a radiopaque contrast media for bolus visualization and examination. Accordingly, the consistency and flow behavior of barium stimuli can differ significantly from their non-barium counterparts. Such differences may have a subsequent impact on the validity of VFSS. Therefore, in this study, effects of barium sulfate on the shear and extensional rheological properties and IDDSI (International Dysphagia Diet Standardization Initiative) flow consistency of liquids prepared using various commercial thickening powders were investigated. Results showed that all barium stimuli exhibited shear thinning behavior but with significantly higher shear viscosity compared to the non-barium counterparts. A shift factor of viscosity at shear rate 50 s -1 with values in range of 1.21-1.73 could be used to describe the increase in the viscosity for samples thickened with gum-based thickeners. However, the change in the viscosity was not invariant for the stimuli prepared starch-based thickener. The addition of BaSO 4 had a negative impact on extensional properties of samples by demonstrating a faster filament rupture. The extent of impact on the decrease in filament breakup time was more pronounced in xanthan > guar gum ≈ tara gum-based thickeners. Based on the IDDSI flow test, no significant effect of BaSO 4 was found on the gum-based thickeners, whereas there was a marked effect in the starch-based sample. These results can be used beneficially to assist clinicians in the dysphagia diagnosis for matching rheological properties of the barium stimuli to enhance effectiveness dysphagia interventions.