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Psyllium is a bulk-forming laxative and is high in both fiber and mucilage. Psyllium seeds contain 10–30% mucilage. The laxative properties of psyllium are due to the swelling of the husk when it comes in contact with water. This forms a gelatinous mass that keeps feces hydrated and soft, provided it is taken with sufficient water. The resulting bulk stimulates a reflex contraction of the walls of the bowel, followed by emptying.18
Psyllium is a common ingredient in over-the-counter bulk laxative products. One preliminary trial found that psyllium seeds relieved constipation when it was due to lifestyle factors (e.g., inadequate fiber, sedentary lifestyle), but not when an actual disease was the cause.19 Numerous double-blind trials have found that supplementation with psyllium can lower total cholesterol and LDL (“bad”) cholesterol.20 However, levels of HDL (“good”) cholesterol are not affected by psyllium supplementation.21 The cholesterol-lowering effect of psyllium has been reported in children,22 as well as in adults.23 Psyllium supplementation has also improved blood sugar levels in some people with diabetes.24, 25, 26 The soluble fiber component of psyllium is believed to account for this effect.
In a double-blind trial, people with ulcerative colitis had a reduction in symptoms such as bleeding and remained in remission longer when they took 20 grams of ground psyllium seeds twice daily with water compared to the use of the medication mesalamine alone.27 Also, the combination of the two was slightly more effective than either alone.
The suggested intake of psyllium husks to treat constipation is 1 teaspoon (approximately 5 grams) three times per day. Alternatively, some references suggest taking 2–6 teaspoons (10–30 grams) of the whole seeds per day—typically taken in three even amounts throughout the day.28 This is stirred into a large glass of water or juice and drunk immediately before it thickens.29 It is best to follow label instructions on over-the-counter psyllium products for constipation. It is important to maintain a high water intake when using psyllium.
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.