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Psyllium Husk for Bowel Health. Should I Try it?

It's a widely available supplement which is believed to be helpful for bowel health and symptoms of Irritable Bowel Syndrome (IBS); but is it a worthy investment? We aim to break down some of the evidence surrounding Psyllium husk, looking particularly at the benefits to gut health.


What Exactly is Psyllium Husk?


Psyllium husk comes from a herb called Plantago ovata that grows worldwide; although most often in India. Each plant may produce up to 15,000 tiny, gel-coated seeds.

Specifically; Psyllium husk is the gelling agent produced from the seed coat, extracted by mechanically milling the outer layer of the seed.



Other names for this source of fibre include Ispaghula or Isabgol husk and are widely available as whole husks, granules, grounded powder or capsules.


Upon absorbing water, Psyllium husk can increase in volume ten-fold or more, making it a useful product for food industries and this function also makes it useful for managing a range of bowel symptoms.


 


How is Psyllium Husk Taken and How Much Do I Take?


You can mix it with fluid to drink straight away, mix it into smoothies, sprinkle on your breakfast, bake it into bread or swallow as a capsule form, there are lots of possibilities!


In terms of dosage, there is a large variation in recommendations. Manufacturers often suggest between 1g-3g per day for adults. However, the The British National Formulary (BNF) suggests up to 7g/day for managing constipation.


Most people start at around 1 level teaspoon a day (1.75g), and increase it to tolerance over the course of a few weeks. It is not recommended to exceed 7g (4 Level teaspoons)/day.


It is important to remember that psyllium husk requires fluid to work effectively, therefore it is recommended to have a glass of water with psyllium husk and maintain a good fluid intake throughout the day.


 

Evaluating the Evidence


Psyllium husk increases your fibre intake; which is a good thing!


UK Government guidelines from 2015 suggest that the UK population should aim for 30g of fibre per day for long-term health benefits and disease prevention; Psyllium husk can be counted towards this.


Fibre supplementation has been shown to be effective for irritable bowel syndrome (IBS) symptoms. Soluble fibre sources such as Psyllium husk, are believed to be better tolerated than insoluble sources when being used to increase fibre intake (8)



It may help your bowel movements to become consistent


If you mix it with water and leave it on the side for a while then you will notice that it creates a gel. This happens due to the soluble fibre it contains, which is not absorbed by the small intestine (2).


Essentially, psyllium husk retains fluid throughout digestion, promoting consistent bowel movements.

However, whilst it is often used for managing constipation, it may also help people with diarrhoea (7)



There is some encouraging evidence surrounding Psyllium husk and the gut microbiome


Our gut microbiome is unique to us, and as such, individual responses to psyllium husk are also evident in scientific studies.


One study has suggested that psyllium husk has a prebiotic nature and encourages the proliferation of certain types of gut bacteria. Interestingly, one study found that different types of bacteria were encouraged to grow between groups of constipated and non-constipated users (1).


However, further evidence is needed to interpret and explore the effects of Psyllium husk upon the gut microbiome.


 

Are There any Precautions When Taking Psyllium Husk?


As with any supplement, there are some factors to consider before taking Psyllium husk

  • It is not recommended to drink Psyllium husk before bedtime or lying down for a long period of time.

  • Introducing Psyllium husk may increase gas and/or abdominal bloating (3,6), this may settle over time.

  • As with any food, there is a risk of an allergic reaction (5)

  • It is essential to take enough fluids with psyllium to prevent a risk of blockage to the digestive system, or bowel obstruction (4)

  • It may interact with other medications. It is important to discuss this with your pharmacist before starting Psyllium husk as to whether this would affect you.


 

To Summarise

  • Psyllium husk can be used for mild to moderate constipation, or even loose stools.

  • It is a simple way to boost your daily fibre intake.

  • There is some encouraging evidence to suggest that Psyllium husk may benefit the gut microbiome.

  • It is recommended to be aware of the risks and considerations before taking psyllium husk.


 

If you want to know more about this and would like to book a 1-1 consultation where we can calculate your average fibre intake, assess your overall gut health and ascertain whether Pyllium husk supplementation would be something you may benefit from; please take a look on our website for further information.


If you want to ask us any questions before booking your consultation, please book in for our FREE discovery call which you can book via our website


Gut love to you all


Cat & Rosie, Registered Dietitians



References

(1) Jalanka J, Major G, Murray K, Singh G, Nowak A, Kurtz C, Silos-Santiago I, Johnston JM, de Vos WM, Spiller R. The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls. Int J Mol Sci. 2019 Jan 20;20(2):433. doi: 10.3390/ijms20020433. PMID: 30669509; PMCID: PMC6358997.


(2) McRorie, Johnson W.; McKeown, Nicola M. (2017). "Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber". Journal of the Academy of Nutrition and Dietetics. 117 (2): 251–264. doi:10.1016/j.jand.2016.09.021. ISSN 2212-2672. PMID 27863994.


3) Christodoulides, S.; Dimidi, E.; Fragkos, K. C.; Farmer, A. D.; Whelan, K.; Scott, S. M. (2016-07-01). "Systematic review with meta-analysis: effect of fibre supplementation on chronic idiopathic constipation in adults". Alimentary Pharmacology & Therapeutics. 44 (2): 103–116. doi:10.1111/apt.13662. ISSN 1365-2036. PMID 27170558. S2CID 34178677.


(4) Abou Azar S, Wehbe MR, Jamali S, Hallal A (2017). "Small Bowel Obstruction Secondary to a Metamucil Bezoar: Case Report and Review of the Literature". Case Rep Surg. 2017 : 2702896. doi:10.1155/2017/2702896. PMC 5632449. PMID 29085697.



(5) Khalili, B.; Bardana, EJ.; Yunginger, JW. (Dec 2003). "Psyllium-associated anaphylaxis and death: a case report and review of the literature". Ann Allergy Asthma Immunol. 91 (6): 579–84. doi:10.1016/S1081-1206(10)61538-4. PMID 14700444.


(6) Dahl, WJ; Stewart, ML (November 2015). "Position of the Academy of Nutrition and Dietetics: Health Implications of Dietary Fiber". Journal of the Academy of Nutrition and Dietetics. 115 (11): 1861–70. doi:10.1016/j.jand.2015.09.003. PMID 26514720


(7) Lambeau KV, McRorie JW Jr. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy. J Am Assoc Nurse Pract. 2017;29(4):216-223. doi:10.1002/2327-6924.12447


(8) Moayyedi P, Quigley EM, Lacy BE, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2014;109(9):1367-74. doi:10.1038/ajg.2014.195


The information and advice offered by Oxford Gastro Dietitians is solely educational and provides general advice only for the adult population. Information offered on Oxford Gastro Dietitians website, blog and social media accounts is not a substitute for seeing a registered dietitian or another health care professional. All opinions are own views.

See more at the ‘Disclaimer’ section of our website.



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