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Psyllium is a medicinal plant that originates from India. The term “Psyllium” is used for the crust, seed and the whole plant. It is considered as a good source for soluble and insoluble fibre, and prebiotic. Its soluble content is almost eight times more than that of oat’s bran (Verma & Morga, 2013). The Psyllium Husk contains 6.83%protein, 4.07% ash and 84.98% of total carbohydrates (Verma & Morga, 2013). Psyllium Husk also contains a high proportion of hemicellulose. The seed consists of 35% soluble and 65% insoluble polysaccharides (cellulose, hemicellulose, and lignin).
Psyllium hydrophilic mucilloid is a natural fibre derived from Psyllium seed husks. It is a highly branched arabinoxylan polysaccharide which has a high water holding and gelling capacity (Verma & Morga, 2013). That is why Psyllium Husk is often referred to as a bulking fibre, because of its bulk forming laxative effect. Once it is ingested; it expands, forming a gel-like mass by drawing water in from the colon. On this way it promotes easy, healthy elimination by sweeping waste out of the colon more quickly and efficiently (Verma & Morga, 2013). By helping with the absorption of water, which increases the size and moisture of stools, Psyllium Husk is considered as an excellent supplement against constipation.
In a study done by Stevens et al. (2008) Psyllium Husk had a greater effect than wheat bran on the moisture, total weight and texture of stools. Stevens et al. (2008) measured gastrointestinal transit time, frequency of defecation, stool weight, and stool consistency in 12 subjects who were each given fibre supplements containing wheat bran, psyllium husk, and a combination of wheat bran and psyllium husk, or a low-fibre control for 2 weeks. Psyllium had a greater effect than wheat bran on the amount of water found in the stools and the total stool weight. On the days that stools were passed, 50% of the daily stool ratings were scored as "hard" when subjects received the control supplement. Less than 10% of the ratings were scored as "hard" when subjects received the psyllium husk supplement (Stevens et al., 2008).
The laxative effect of Psyllium Husk was confirmed in another study done by McRorie et al. (2011). McRorie et al. (2011) compared the laxative effect of Psyllium Husk with Dioctyl Sodium Sulphosuccinate (Docusate Sodium), a well-known synthetic anionic detergent used as a stool softener laxative. This study identified that Psyllium Husk is superior to Docusate Sodium for softening stools by increasing stool water content, and has greater overall laxative efficacy in subjects with chronic idiopathic constipation (McRorie et al., 2011). Effects of Psyllium Husk on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation were also assessed in a study done by Ashraf et al. (2005). In this study Ashraf et al. (2005) concluded that taking 5.1 grams Psyllium Husk twice a day for two weeks can significantly increase the water content and weight of stools, as well as the total number of bowel movements, in 170 individuals with idiopathic constipation.
Psyllium Husk has also been shown to relieve diarrhoea; and it does this by acting as a water-absorbing agent, which can increase stool thickness and slow down its passage through the colon (Singh, 2007). Psyllium Husk significantly decreased diarrhoea in 30 cancer patients undergoing radiation therapy (Murphy et al., 2000). In another study, Psyllium has been reported to inhibit lactulose-induced colonic mass movements and to benefit patients with irritable bowel syndrome, improving both, constipation and diarrhoea (Washington et al., 2008).
The gel-forming ability of Psyllium Husk has the added benefit of regulating blood sugar and cholesterol levels (Ganji & Kies, 2009). A study done by Anderson et al. (1999) examined the effects of administering psyllium to men with type 2 diabetes. In this study, Psyllium husk decreased postprandial glucose concentrations and serum cholesterol concentrations in men with type 2 diabetes and hypercholesterolemia (Anderson et al., 1999). In another study, higher daily dose (5g consumed three times per day) of Psyllium Husk, for six weeks resulted in a 29% reduction in blood sugar levels within the first two weeks, in patients with type 2 diabetes (Rodriguez et al., 1998). This indicates that a higher daily dose (at least 10g) of Psyllium Husk can promote lower blood glucose levels.
The cholesterol lowering effect of Psyllium Husk is due to its ability in promoting the removal of bile acids from the body. Psyllium Husk is able to bind to fat and bile acids, and promotes their excretion from the body. In the process of replacing these lost bile acids, the liver uses cholesterol to produce more. As a result, blood cholesterol levels decrease. Psyllium Husk has been shown not only to lower LDL cholesterol, but also increase HDL cholesterol significantly. In a study done by Wei et al. (2009) Psyllium Husk was shown to produce dose and time dependent serum LDL cholesterol-lowering effect in mild and moderate hypercholesteraemic patients. On the other hand, the study by Rodriguez et al. (1998) has pointed out towards HDL cholesterol increasing ability of Psyllium Husk where participants who were taking a higher daily dose experienced increases in HDL cholesterol up to 45.7%.
Psyllium Husk is also known prebiotic, nourishing the healthy-probiotic bacteria in the gut and helping them to grow. It can promote short-chain fatty acid production and decrease digestive discomfort in patients with ulcerative colitis and Crohn's disease. In a study done by Fujimori et al. (2009) a combination of Psyllium and probiotics was shown to be particularly effective at treating ulcerative colitis and Crohn's disease.
Psyllium appears to be well tolerated by most people. Doses of 5-10 grams taken three times per day are not linked to serious side effects. However, some cramping, gas or bloating may occur. Also, psyllium could delay the absorption of certain medications. Therefore, it's not recommended to take it with any other medicines.
Psyllium can be consumed in doses of 5-10 grams with meals, at least once per day. However, when it comes to fibre, more is not always better. The benefits seen in most studies are linked with intakes of 3-20 grams per day, and taking more may cause digestive problems. It is important to take it with water and then drink water regularly throughout the day. As a bulk laxative supplement, 5 grams with a glass of water three times per day is often recommended as a starting point. This can be gradually increased, as tolerated. It depends on the product how many grams are contained in a teaspoon or tablespoon, but a tablespoon is often recommended as a serving for Psyllium Husk.
BSc Herbal Medicine; MSc Pharmacology
Anderson, J.W., Allgood, L.D. et al. (1999). Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. The American Journal of Clinical Nutrition. 70 (4), 466-470.
Ashraf, W., Park, F., Lof, J., Quigley, E.M. (2005). Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Alimentary Pharmacology and Therapeutics. 9 (6), 639-647.
Fujimori, S., Gudis, K., Mitsui K. et al. (2009). A randomized controlled trial on the efficacy of synbiotic versus probiotic or prebiotic treatment to improve the quality of life in patients with ulcerative colitis. Nutrition. 25 (5), 250-255.
Ganji, V., Kies, C.V. (2009). Psyllium husk fibre supplementation to the diets rich in soybean or coconut oil: Hypocholesterolaemia effect in healthy humans. International Journal of Food Sciences and Nutrition. 6 (9), 103-110.
Murphy, J., Stacey, D. et al. (2000). Testing control of radiation-induced diarrhoea with a psyllium bulking agent: a pilot study. Canadian Oncology Nursing Journal. 10 (3), 96-100.
McRorie, J.W., Daggy, B.P. et al. (2011). Psyllium is superior to docusate sodium for treatment of chronic constipation. Alimentary Pharmacology and Therapeutics. 12 (5), 491-499.
Rodríguez-Morán, M., Guerrero-Romero, F., Lazcano-Burciaga, G. (1998). Lipid and glucose lowering efficacy of Psyllium in type II diabetes. Journal of diabetes and its complications. 12 (5), 273-278.
Singh, B. (2007). Psyllium as therapeutic and drug delivery agent. International Journal of Pharmaceutics. 4 (2), 334-352.
Stevens., J, VanSoest, P.J. et al. (2008). Comparison of the effects of psyllium and wheat bran on gastrointestinal transit time and stool characteristics. Journal of American Dietary Association. 88 (3), 323-326.
Verma, A., Morga, R. (2013). Psyllium Husk: A wonder food for good health. International Journal of Science and Research. 13 (6), 438-442.
Washington, N., Harris, M., Mussellwhite, A., Spiller, R.C. Moderation of lactulose-induced diarrhoea by psyllium: effects on motility and fermentation. The American Journal of Clinical Nutrition. 67 (2), 317-321.
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