- PSYLLIUM :
Psyllium is a soluble fiber
used primarily as a gentle bulk-forming laxative. It comes from a shrub-like
herb called plantain that grows worldwide. There are many species of
plantain that can each produce up to 15,000 tiny, gel-coated seeds.
The plantain herb that produces psyllium seed is not the same plant
as edible plantains. Psyllium husk is derived from these odorless, tasteless
seeds.
The soluble fiber found in psyllium husks
plays an important role in lowering cholesterol. Psyllium also softens
stool and relieves constipation, irritable bowel syndrome, hemorrhoids,
and other intestinal problems. When psyllium husk comes in contact with
water, it swells and forms a gelatinous mass that stimulates the transport
of waste through the intestinal tract. Several large population based
studies also suggest that there may be an association between increased
fiber intake and reduced risk of colon cancer, but results of other
studies have been conflicting.
Unlike wheat bran and some other fiber
supplements, psyllium generally does not cause excessive gas and bloating.
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Uses
Constipation
Many well-designed studies have concluded that psyllium relieves constipation.
Psyllium is believed to speed the passage of stool through the digestive
tract by softening the stool and attracting water thereby producing
more bulk, which stimulates the transit of waste through the gastrointestinal
tract. Use of psyllium for this purpose is standard practice in Asia,
Europe, and North America.
Diarrhea
Psyllium can be used as a bulk-forming agent to help relieve mild to
moderate diarrhea. Psyllium soaks up a significant amount of water in
the digestive tract, thereby making stool firmer and, under these circumstances,
slower to pass.
Irritable Bowel Syndrome (IBS)
Several well-designed studies have found that soluble fiber (including
psyllium) helps regulate stool frequency and consistency in people with
IBS. Psyllium also has the additional advantages over other sources
of fiber of reducing flatulence and bloating.
Hemorrhoids
Psyllium may be recommended by a physician to help soften stool and
reduce the pain associated with hemorrhoids.
Inflammatory Bowel Disease (IBD)
In a study of people with ulcerative colitis (a type of inflammatory
bowel disorder), psyllium seeds were as effective as the prescription
drug mesalamine in decreasing recurrences of the disease. In addition,
a physician may recommend the use of psyllium as a bulking agent for
mild to moderate cases of diarrhea from either ulcerative colitis or
Crohn's disease (another type of inflammatory bowel disorder).
High Cholesterol
Soluble fibers such as those in psyllium husk, guar gum, and oat bran
have a cholesterol-lowering effect when added to a low-fat, low-cholesterol
diet. Studies have shown psyllium to be quite effective in lowering
total as well as LDL ("bad") cholesterol levels, which can
be helpful to those with high cholesterol (hypercholesterolemia) and
those at increased risk for developing hypercholesterolemia, such as
people with type 2 diabetes.
Diabetes
Studies suggest that a high-fiber diet, which may include psyllium,
an lower insulin and blood sugar levels and improve cholesterol and
triglyceride levels in people with diabetes. This type of diet may also
help prevent diabetes in those at risk for the condition.
Obesity
Studies and clinical reports suggest that psyllium may enhance the sensation
of fullness and reduce hunger cravings. For these reasons, incorporating
psyllium and other sources of fiber into the diet may aid weight loss.
High Blood Pressure
Although the studies are not entirely conclusive, the addition of fiber
(namely, 12 grams of soluble fiber per day), particularly psyllium,
may help lower blood pressure.
Heart Disease
Incorporating high-fiber foods (such as psyllium-enriched cereals) into
the diet may help lower heart disease risk.
Colon Cancer
Although initial reports were promising, studies investigating the value
of a high-fiber diet for colorectal cancer have been conflicting. While
some studies evaluating groups of people have suggested that fiber protects
against the development of colorectal cancer, most large, better-designed
studies have found only a minimal association between fiber intake and
colorectal cancer risk. In addition, fiber does not appear to protect
against the recurrence of colorectal cancer in people who have already
been treated for the condition.
Other types of cancer
Preliminary evidence suggests that a diet high in fiber (in conjunction
with other lifestyle changes and conventional medication) may help protect
against the development of certain types of cancer such as prostate,
breast, and lining of the uterus. Further studies are needed to confirm
these findings, however.
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Dietary Sources
Psyllium seed
Psyllium husk
Psyllium is also added to some cereals to increase fiber content
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Available Forms
Standard preparations of psyllium are available in dry seed or husk
form, to be mixed with water as needed. Psyllium is an ingredient in
some commercially prepared laxatives.
It is important to note that most commercial
preparations consist of blonde psyllium. Another type of psyllium, called
black psyllium, may also be used as a bulk laxative and carries the
same risks as blonde psyllium, but is not typically found in commercial
psyllium preparations.
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How to Take It
Pediatric
Most experts recommend that children should
obtain fiber from dietary sources. Psyllium supplements should only
be taken under the guidance of a qualified healthcare practitioner.
In general, half the typical adult dosage of psyllium supplements is
recommended for children between the ages of 6 of 12.
Adult
Add 1/2 to 2 tsp of psyllium seed to 1
cup (8 oz) of warm water. Mix well, and then drink immediately before
it becomes too thick to swallow comfortably. (Psyllium thickens rapidly
when water is added to it.) If using a commercial product that contains
psyllium, follow package directions.
For those not accustomed to taking psyllium,
it is best to begin with a low dose (such as 1/2 tsp in an 8 oz glass
of water once a day), then increase to 2 tsp in two 8 oz glasses of
water per day, as needed.
Higher doses of psyllium may be recommended
by a health care provider to treat certain conditions. In the case of
irritable bowel syndrome, for example, an initial dose of 1/2 to 1 tsp
of psyllium per day is gradually increased to 4 doses per day.
Psyllium can be taken first thing in the
morning or before bedtime. As a weight-loss aid, take at least 30 minutes
before meals.
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Precautions
Because supplements may have side effects or interact with medications,
they should be taken only under the supervision of a knowledgeable healthcare
provider.
In general, psyllium supplements may reduce
or delay the absorption of certain medications. For this reason, it
is best to refrain from taking psyllium or fiber supplements at the
same time as other medications. Instead, medications should be taken
at least one hour before or between two and four hours after taking
psyllium.
Psyllium should always be taken with a
full 8 oz glass of water. It is also important to drink at least 6 to
8 full glasses of water throughout the day or constipation may develop.
Taking psyllium supplements without adequate liquids may cause it to
swell, and, in extreme causes, cause choking. Do not take this product
if you have difficulty swallowing. People with esophageal stricture
(narrowing of the esophagus) or any other narrowing or obstruction of
the gastrointestinal tract should not take psyllium.
If you experience chest pain, vomiting,
or difficulty swallowing or breathing after taking fiber supplements,
seek immediate medical attention.
A potential side effect from any fiber
product is gas and bloating.
Although very uncommon, allergic reactions
(even anaphylaxis) to psyllium may develop in people who consume psyllium
over a long period of time.
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Possible Interactions
If you are currently being treated with any of the following medications,
you should not use psyllium supplements without first talking to your
healthcare provider.
Antidepressant Medications, Tricyclics
Dietary fiber has been shown to lower the blood levels and effectiveness
of tricyclic antidepressant medications such as amitriptyline, doxepin,
and imipramine in three patients. Reduced dietary fiber intake increased
the blood levels and improved symptoms in these patients. Individuals
taking tricyclic medications should consult a healthcare provider before
increasing psyllium intake.
Carbemazepine
Taking psyllium with carbamazepine, a medication used to treat seizure
disorders, may decrease the absorption and effectiveness of carbamazepine.
If taking psyllium and carbamazepine, blood levels of carbamazepine
should be monitored closely by a healthcare provider.
Cholesterol-lowering Medications, Bile
Acid Sequestrants
Combining psyllium with the cholesterol-lowering medications classified
as bile acid sequestrants, such as cholestyramine or colestipol, may
be beneficial in lowering cholesterol levels and may reduce side effects
of colestipol. Consult with your healthcare practitioner about whether
this may be an option for you.
Diabetes Medications
While fiber supplements may help to regulate blood sugar levels, they
may also interfere with the absorption of anti-diabetic medications,
specifically glyburide and metformin. Therefore, fiber supplements should
not be taken at the same time as these drugs.
Digoxin
Fiber supplements may reduce the body's ability to absorb digoxin, a
medication used to regulate heart function. Therefore, it is likely
that psyllium and psyllium supplements would similarly interfere with
the absorption of digoxin and should not be taken at the same time as
this medication.
Lithium
Reports suggest that psyllium may lower lithium levels in the blood,
reducing the effectiveness of this medication. If both are used, they
should be taken at least one hour apart, preferably two. Lithium levels
should be monitored very closely by a healthcare provider, particularly
if there is any significant change in fiber intake.
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