Side Effects of psyllium: A Synthesis of Findings from 19 Studies

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Original Abstract of the Article

Major Research Findings

Psyllium is a type of dietary fiber that is often used to treat constipation and lower cholesterol levels. 5 , 13 However, there is a possibility of some side effects from psyllium intake. 2 , 19 , 11 , 1 The amount of psyllium intake affects the risk of side effects. 2 Side effects from psyllium intake vary from person to person, so caution is necessary. 2

Reasons for Side Effects

Psyllium is a type of dietary fiber that forms a gel when mixed with water. 13 This gel absorbs water in the intestines and increases the volume of stool. 13 Therefore, psyllium is effective in treating constipation, but excessive intake can lead to a lack of water in the intestines, potentially worsening constipation. 2 In addition, psyllium is fermented by intestinal bacteria, which can produce gas. 2

Common Side Effects

Abdominal Distention

Psyllium intake can lead to abdominal distention and gas production. 2 , 6 These symptoms can occur as psyllium absorbs water in the intestines and increases the volume of stool. 13 , 6 Psyllium can also be fermented by intestinal bacteria, leading to gas production. 2

Constipation

Psyllium is effective in treating constipation, but excessive intake can lead to a lack of water in the intestines, potentially worsening constipation. 2 , 6

Diarrhea

Psyllium may worsen diarrhea symptoms. 2 , 11

Allergy

Psyllium can cause allergic reactions. 19 Those with psyllium allergies should avoid psyllium intake. 19

Measures to Counteract Side Effects

Measures for Abdominal Distention

To reduce abdominal distention and gas, it is important to start with small amounts of psyllium and gradually increase the intake. 2 It is also important to consume sufficient fluids. 6

Measures for Constipation

If constipation worsens, discontinue psyllium intake and consult a doctor. 2

Measures for Diarrhea

If diarrhea persists, discontinue psyllium intake and consult a doctor. 2

Measures for Allergy

If you have a psyllium allergy, avoid psyllium intake. 19

Comparison Between Studies

Commonalities in Studies

Many studies indicate that psyllium is effective in treating constipation and lowering cholesterol levels. 5 , 13 Furthermore, studies have reported that psyllium may cause side effects such as abdominal distention, gas, and diarrhea. 2 , 19 , 11 , 1

Differences in Studies

The incidence and symptoms of psyllium-related side effects vary depending on the study. 2 , 19 , 11 , 1 The incidence and symptoms of side effects may also vary depending on the amount and method of psyllium intake. 2

Precautions for Real-Life Applications

Psyllium has been shown to be effective in treating constipation and lowering cholesterol levels, but it also poses a risk of side effects. 5 , 13 Consult a doctor or pharmacist before taking psyllium and ensure you are taking the appropriate amount. 2 If you experience any changes in your health after taking psyllium, stop taking it immediately and consult a doctor. 2

Limitations of Current Research

There is still not enough research on the side effects of psyllium. 2 Future research needs to elucidate the detailed mechanisms of psyllium-related side effects and explore ways to use psyllium more safely. 2

Future Research Directions

Future research should clarify the relationship between psyllium intake and side effects. 2 Research is also needed on the effects of psyllium intake on changes in the gut environment and its impact on the immune system. 2

Conclusion

Psyllium is known to be effective in treating constipation and lowering cholesterol levels, but it may cause side effects such as abdominal distention, gas, and diarrhea. 5 , 13 , 2 Consult a doctor or pharmacist before taking psyllium and ensure you are taking the appropriate amount. 2 If you experience any changes in your health after taking psyllium, stop taking it immediately and consult a doctor. 2

Literature analysis of 19 papers
Positive Content
16
Neutral Content
0
Negative Content
2
Article Type
10
0
1
6
19
1.

Gastrointestinal side effects of orlistat may be prevented by concomitant prescription of natural fibers (psyllium mucilloid).

Author: CavaliereH, FlorianoI, Medeiros-NetoG

Obesity treatment
Gastrointestinal side effects

This placebo-controlled open study investigated whether the use of natural fibers (psyllium mucilloid) could prevent or ameliorate gastrointestinal (GI) side events induced by orlistat, a gastrointestinal lipase inhibitor, in obese patients.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Gastrointestinal Effects and Tolerance of Nondigestible Carbohydrate Consumption.

Author: MysonhimerAnnemarie R, HolscherHannah D

Gastrointestinal health
Gastrointestinal side effects

This review summarizes the tolerable intake levels of nondigestible carbohydrates (NDCs) that are classified as dietary fibers. Tolerable intake levels are NDC-specific and can range from 3.75 g/d for alginate to 25 g/d for soy fiber. Overconsumption can lead to undesirable gastrointestinal side effects. Future studies should explore a wider range of NDC doses and consumption forms.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Non-pharmacologic approach to pediatric constipation.

Author: SantucciNeha R, ChogleAshish, LeibyAlycia, MascarenhasMaria, BorlackRachel E, LeeAmanda, PerezMaria, RussellAlexandra, YehAnn Ming

Mind-body interventions
Non-pharmacologic treatment

This review discusses non-pharmacological approaches to treat functional constipation in children. Some supplements like prebiotics, probiotics, and fiber show promise, but evidence for other supplements and botanicals is limited. Mind-body interventions and movement/manipulative interventions may also be beneficial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

Polysaccharides from natural resources exhibit great potential in the treatment of ulcerative colitis: A review.

Author: NiuWei, ChenXiaoqing, XuRuling, DongHuimin, YangFuyan, WangYun, ZhangZhenhai, JuJianming

Polysaccharides from natural resources are emerging as promising therapeutic agents for ulcerative colitis (UC). This review highlights the recent advances in using polysaccharides for treating UC, discussing their mechanisms of action and potential benefits in regulating inflammatory cytokines, intestinal flora, and immune responses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Systematic review of stimulant and nonstimulant laxatives for the treatment of functional constipation.

Author: ParéPierre, FedorakRichard N

Constipation treatment

Constipation is a common condition that affects people of all ages. This review explores the history of constipation treatment and prevention, noting that approaches have varied significantly throughout history.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Fiber and macrogol in the therapy of chronic constipation.

Author: StanghelliniV, BellacosaL, CogliandroR

Constipation treatment

This study discussed the challenges of chronic constipation treatment and highlighted the benefits of polyethylene glycol (PEG) and psyllium as effective laxatives.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

A randomized, prospective, comparison study of a mixture of acacia fiber, psyllium fiber, and fructose vs polyethylene glycol 3350 with electrolytes for the treatment of chronic functional constipation in childhood.

Author: QuitadamoPaolo, CoccorulloPaola, GiannettiEleonora, RomanoClaudio, ChiaroAndrea, CampanozziAngelo, PoliEmanuela, CucchiaraSalvatore, Di NardoGiovanni, StaianoAnnamaria

Constipation treatment

A mixture of acacia fiber, psyllium fiber, and fructose (AFPFF) was found to be as effective as polyethylene glycol 3350 combined with electrolytes (PEG+E) in treating children with chronic functional constipation (CFC). AFPFF was also found to be safe and effective in treating children with CFC.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effect of four-day psyllium supplementation on bowel preparation for colonoscopy:A prospective double blind randomized trial [ISRCTN76623768].

Author: SalwenWalter A, BassonMarc D

Colonoscopy preparation

The study investigated the impact of preliminary fiber supplementation on the tolerability and efficacy of bowel preparation for colonoscopy in patients with constipation or hemorrhoid bleeding.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

A study to assess the effect of dietary supplementation with soluble fibre (Minolest) on lipid levels in normal subjects with hypercholesterolaemia.

Author: TaiE S, FokA C, ChuR, TanC E

Cholesterol lowering

Minolest produced a 3.24% decrease in total cholesterol and 5.45% decrease in LDL cholesterol but no significant difference in serum triglyceride, weight, body mass index or blood pressure. There were few side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

The moderate intestinal side effects of auranofin do not require prophylactic therapy with a bulkforming agent. Dutch Ridaura Study Group.

Author: van BeusekomH J, van de LaarM A, FranssenM J, van ValburgJ A, GijzelW P, CouvéeJ E

Auranofin treatment
Diarrhea
Loose stools

Auranofin, a drug used to treat rheumatoid arthritis, can cause diarrhea and loose stools in up to 50% of patients. This study investigated whether a bulk-forming agent could reduce these side effects. While a slight improvement in stool consistency was observed in the bulk-forming group, the overall incidence of diarrhea remained similar to the placebo group. The results suggest that a bulk-forming agent is not beneficial in reducing auranofin-induced diarrhea, and that increasing the auranofin dosage might be a better option to enhance its efficacy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

12.

Psyllium for the reduction of cholestyramine-associated gastrointestinal symptoms in the treatment of primary hypercholesterolemia.

Author: MaciejkoJ J, BrazgR, ShahA, PatilS, RubenfireM

Cholesterol reduction
Gastrointestinal side effect reduction

The study found that psyllium hydrophilic mucilloid (PHM) significantly reduced the frequency and severity of gastrointestinal side effects associated with cholestyramine therapy, such as constipation, abdominal discomfort, and heartburn. While PHM showed a tendency toward further reductions in total cholesterol and LDL-C levels, this effect did not reach statistical significance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Cholesterol-lowering effects of psyllium hydrophilic mucilloid. Adjunct therapy to a prudent diet for patients with mild to moderate hypercholesterolemia.

Author: BellL P, HectorneK, ReynoldsH, BalmT K, HunninghakeD B

Lowers cholesterol

Psyllium hydrophilic mucilloid, a soluble fiber, lowered cholesterol levels in patients with mild to moderate hypercholesterolemia. It effectively reduced total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels without affecting blood pressure or other vital parameters.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Treatment of chronic diarrhoea: loperamide versus ispaghula husk and calcium.

Author: QvitzauS, MatzenP, MadsenP

Chronic Diarrhea Treatment

Ispaghula and calcium were found to be a cheap and effective alternative to conventional treatment of chronic diarrhoea, halving stool frequency and improving urgency and stool consistency.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

15.

Clinical evaluation of methylcellulose as a bulk laxative.

Author: HamiltonJ W, WagnerJ, BurdickB B, BassP

Fecal frequency increase
Laxative efficacy

Methylcellulose effectively increased fecal weight and frequency in both normal subjects and chronically constipated individuals. Doses as low as 1 g showed significant laxative effect.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

A crossover comparative study with two bulk laxatives.

Author: PersM, PersB

Effective for constipation
No side effects

Both Agiolax and Lunelax comp., containing senna glucosides, were effective in treating severe constipation in elderly patients without any side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Cervical dilatation in late first trimester termination by prostaglandin, hylase and isogel.

Author: MandlekarA V, GanguliA C, KrishnaU R, PurandareV N

Cervical dilatation
Softened cervix
Gastrointestinal disturbances
Side effects

Pre-operative cervical dilatation was attempted in 223 patients seeking late first trimester termination. Intra-cervical prostaglandin injections were the most effective method, achieving dilatation in 86% of cases within 4 hours. Side effects were generally mild and included gastrointestinal disturbances.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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