A unique method to model human swallowing dysfunctions

Having difficulties with swallowing, dysphagia, is more common than one might think. For some, it might be enough to add a gelling agent to the morning coffee, but for others, dysphagia severely affects their health and life expectancy. To facilitate research and food product development to ease swallowing problems, RISE Institute of Gothenburg has developed a unique high-technology model, mimicking and analyzing the swallowing function in the human throat.

How to ease what is incureable? We have spoken with Professor Olle Ekberg, Senior Professor of Diagnostic Radiology at Lund University, Sweden, and Professor Mats Stading, Senior Scientist at Product Design and Adjunct Professor at Industrial and Materials Science at Chalmers University of Technology, and RISE –Research Institute of Sweden. They were both deeply involved in developing the throat model in cooperation with other scientists and medical experts.

Professor Olle Ekberg, Senior Professor of Diagnostic Radiology at Lund University, Sweden.
Professor Mats Stading, Senior Scientist at Product Design and Adjunct Professor at Industrial and Materials Science at Chalmers University of Technology, and RISE – Research Institute of Sweden

The model relies on Incipientus’ technology to analyze every change in the flow of the pharynx. Incipientus provides visualization and velocity profiles from the throat, generating valuable, useful, and precise data. The Gothenburg Throat Model is an extraordinary research achievement, benefiting both the food industry and the vast number of people with dysphagia who will get safer and better food developed faster than before. Thanks to this model, it is possible to follow the food’s path through the human throat without using human subjects.

Food industries want their own high-tech throat model

The model is used in research for the food industry, proving to work so well that commercial orders are beginning to take off.

“We are building one to order right now, and more companies have shown interest,” says Professor Mats Stading.

Swallowing problems, or dysphagia, is common and can be caused by several factors, and the risk of being affected increases with age. Dysphagia can be caused by physical obstacles such as throat cancer. Causes can also be neurological diseases such as stroke or dementia, creating a dysfunction.

“Many of the underlying conditions behind dysphagia is not treatable. But the swallowing dysfunction is helped by a texture modified diet. It is greatly important to continuously develop and improve this food ” says Professor Olle Ekberg, a Professor of Diagnostic Radiology at Lund University, Sweden. He is also a Senior Consultant in the Department of Medical Imaging and Physiology, Skåne University Hospital. With Ekberg’s expertise in the field, he was deeply involved as a consultant during the construction of the Gothenburg Throat Model.

Incipientus' technology was on the table from the planning stage of the Gothenburg Throat Model

The joy of eating is essential

Dysphagia is a symptom that can have significant consequences, and there is much to be gained if it is possible to reduce the problems. It is vital to find ways to improve the situation for those affected. The ability and joy of eating a varied diet and keeping a good appetite are essential to staying healthy.

“When you can’t swallow, you quickly become frail. It starts with eating less, which leads to you becoming weaker and losing muscle mass, which leads to a higher risk of falling and injuring yourself. And that can be devastating for an elderly or sick person,” Mats Stading explains.

High-tech sensor technology is needed since swallowing is fast – all data needs to be captured in just a second or two. Incipientus’ technology was on the table from the planning stage. With pulsed ultrasound measurements, Incipientus can visualize the flow and provide a complete velocity profile of the transportation of the food or drink in the pharynx during swallowing.

"When you can't swallow, you quickly become frail."

Speeding up the process

The Gothenburg Throat Model is designed to develop texture-modified meals. Food and drinks can be adapted for people with various swallowing difficulties. It is valuable to know if different additives make the diet easier to swallow. Before the Gothenburg Throat Model existed, tests had to be conducted on humans, often a very unpleasant experience for the participants and time-consuming for the researchers.

While it is manageable to find people willing to take part in the tests, finding a correct selection of participants is challenging.

“It’s challenging to find people with the same dysfunction. It takes a long time to find just 25 people with stable illnesses. The Gothenburg Throat Model is thus a significant advantage since it can accurately mimic human swallowing. It means so much to be able to carry out tests at a faster pace,” says Olle Ekberg.

The initial idea of the Gothenburg Throat Model was to test which fluid is easiest to swallow.

“A thin liquid is complex for a person with dysphagia; drinks need to be more viscous. But not too dense, then it will become lumpy and harder to swallow. So, the idea was to find the ideal consistency,” says Olle Ekberg.

Discovering the importance of elasticity

Finding the right balance in viscosity requires many tests with comparable data, a perfect challenge for the Gothenburg Throat Model. Industry and researchers can test countless times, whenever it is needed, and receive reliable results. In this way, the next generation of texture-modified foods develops faster and positively affects people sooner.

“It is incredibly clever having a mechanical model for testing different liquids,” says Olle Ekberg.

“We discovered how big a difference elasticity makes. This has not been possible to measure before,” adds Mats Stading.

It is a slightly slimy, oyster-like texture that has proven the easiest to swallow, holding the sip together. A bit of carbonation and a little acid in a drink is also known to make it easier to swallow. The substance capsaicin, found in chili, has lately been shown to trigger the swallowing reflex. On the other hand, if the food is high in fat and too rich, it will negatively affect the ability to swallow.

"It is incredibly clever having a mechanical model for testing different liquids."

Avoiding unnecessary risks for patients

“Usually, persons with swallowing dysfunction have had to make ‘live tests’ to find out what works best for them. How fluid the consistency needs to be, what viscosity is just right, and how big bites the person can take without discomfort and coughing,” says Mats Stading.

People with swallowing difficulties may come to Olle Ekberg and undergo X-ray examinations to learn more about their dysphagia.

“With X-rays, you can see how the transport through the throat is managed. We can detect if there are any changes in the throat, such as cancer or strictures. But we can also see dysfunctions in different muscle groups,” Professor Ekberg explains.

Analyzing the flow in human throats as well

But the specialist care that X-ray entails in hospitals is only available to those with significant problems. Many people who experience difficulties swallowing do not receive specialist care. To open up the possibility of examining a broader spectrum of persons with dysphagia, Incipientus’ technology and manageable products could be a perfect fit in the future. Trials have already been performed, and the technology can be used clinically.

“We have tested using Incipientus flow visualizer and sensors to measure also directly on people (in vivo). We used the instruments on their throats to measure the flow of their swallowing – and it worked great. Even primary care or nursing homes could use Incipientus’ technology in a commercial product design. There is a great need,” says Mats Stading.

"Even primary care or nursing homes could use Incipientus' technology in a commercial product design. There is a great need."