The allergenicity of psyllium seed. Report of a case.
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BACKGROUND AND AIM: The importance of dietary fibres in treatment of irritable bowel syndrome increased during the last years. Yet the results of clinical studies on the different dietary fibres are not consistent. Therefore we decided to perform a controlled trial with a well defined group of patients to compare the effectiveness of wheat bran to psyllium seeds. PATIENTS AND METHODS: Thirty patients each with irritable bowel syndrome group II to III were treated in an open, not controlled study design either with 3 times 3.25 g psyllium seeds or 3 times 7 g wheat bran daily. All patients entering the study had not been treated for at least 3 weeks before. The study comprised two treatment phases of two weeks each, separated by two weeks without any treatment, thus leading to a study duration of 6 weeks altogether. Parameters for evaluation were stool frequency and consistency and the symptoms pain and abdominal distention, measured by a score (1 to 4). RESULTS: In both treatments groups stool frequency and consistency improved apparently compared to the starting point or the two weeks treatment free time in between. The improvement of stool frequency was statistically significant (p < 0.0001) for both substances. Furthermore the effect of psyllium seeds exceeded that of wheat bran statistically significant in week 1, 2, 3, 5 and 6 (p < 0.005). Other symptoms such as abdominal pain improved too by therapy, psyllium seeds again tending to show better results. A significant difference between both substances could be observed on the symptom abdominal distension. Whereas abdominal distension decreased under treatment with psyllium seeds it increased with wheat brain. This lead to discontinuation of the study in 5 cases, 3 of which could be changed successfully to psyllium seeds. The difference between psyllium seeds and wheat bran concerning the occurrence of abdominal distension was statistically significant (p < 0.01). CONCLUSION: The results of this study demonstrate the effectiveness of psyllium seeds and wheat bran on stool frequency and consistency of patients with irritable bowel syndrome. Psyllium seeds showed to be superior to wheat brain with respect to stool frequency and abdominal distension so that it should be preferred in treatment of irritable bowel syndrome and constipation.
Dietary soluble-fiber sources such as pectin, guar gum, or psyllium decrease plasma concentrations of low-density-lipoprotein (LDL) cholesterol in guinea pigs by distinct mechanisms, including increases in LDL apolipoprotein (apo) B turnover and/or decreases in LDL apo B flux (J Lipid Res 1995; 36:2394-404). The present studies were undertaken to test whether changes in the rates of very-low-density lipoprotein (VLDL) apo B secretion, VLDL conversion to LDL, and hepatic uptake of VLDL were related to the cholesterol-lowering actions of these soluble fibers. Guinea pigs were fed (by wt) 12.5% pectin, 12.5% guar gum, 7.5% psyllium, or a control diet containing cellulose as the fiber source. Plasma cholesterol concentrations were significantly lower in guinea pigs fed pectin, guar gum, and psyllium by 42%, 46%, and 35%, respectively (P < 0.001), compared with those animals fed the control diet, whereas plasma triacylglycerol concentrations were lower only with guar gum intake. The secretion rate of triacylglycerol, determined after Triton was injected to block VLDL catabolism, was not different among dietary treatment groups whereas the secretion rate of apo B was lower with pectin, guar gum, and psyllium intakes (P < 0.01). In addition, pectin, guar gum, and psyllium significantly altered the composition of newly secreted VLDLs by increasing the number of triacylglycerol and phospholipid molecules in the secreted lipoprotein, indicating the presence of larger nascent VLDLs. In contrast, the average particle diameter of mature VLDLs as determined by electron microscopy was smaller in the dietary soluble-fiber groups in the following order: pectin < psyllium < guar gum. Plasma lecithin-cholesteryl acyltransferase and cholesteryl ester transfer protein activities were lower with intake of pectin, guar gum, and psyllium (P < 0.01). Injection of radiolabeled lipoproteins indicated that pectin, guar gum, and psyllium intakes resulted in more rapid VLDL and LDL apo B turnover and lower LDL apo B flux in guinea pigs fed guar gum and psyllium. These results suggest that the secretion rate of apo B, compositional changes in lipoproteins occurring in the intravascular compartment, and up-regulation of LDL receptors-associated with faster LDL apo B turnover rates-are secondary metabolic responses induced by dietary fiber that contribute to the lowering of plasma cholesterol concentrations.
OBJECTIVES: The aim of the present study was to search for a synergetic action between psyllium and a defecation-inducing drug, Eductyl, for symptom relief in patients suffering from chronic constipation. METHODS: Twenty healthy volunteers and 20 patients complaining of chronic constipation were included in a randomized crossover study. The study was divided into four 2-weeks periods: pre-inclusion and three periods of treatment with psyllium, Eductyl, and Eductyl + psyllium respectively. Colonic transit time was determined at the end of each period of treatment. During each of the four periods, a self-administered questionnaire was used to assess symptoms of constipation. RESULTS: For constipated patients, treatment with Eductyl and Eductyl-psyllium improved clinical symptoms of constipation: increased stool frequency, resulted in fewer hard stools and less sensation of incomplete evacuation and less straining to defecate. The improvement was associated with a decrease in total and segmental colonic transit time. The Eductyl-psyllium combination did not exhibit any synergetic effect. CONCLUSION: Treatment with Eductyl alone is more efficient than with psyllium alone in providing symptom relief. Combination with psyllium is not synergetic.
BACKGROUND: Psyllium is the seed of the plant Plantago ovata, which is widely used in nonprescription laxatives. It has been reported that psyllium powder may act as an inhalant allergen, especially in the workplace. A patient with asthma due to inhalation of P. ovata seed powder is described, being highlighted the allergenic potential of this substance frequently used as a laxative. We report a 31 year-old atopic woman, who handled and prepared at home, twice daily, a laxative containing P. ovata seeds (Plantaben) prescribed to her paralytic mother. METHODS AND RESULTS: Skin prick test to psyllium powder extract was positive. Specific IgE antibodies to psyllium were positive as determined by ELISA. Methacholine inhalation test revealed mild bronchial hyperresponsiveness (PC20 = 1.5 mg/ml). Specific bronchial challenge to psyllium powder elicited an isolated early asthmatic response. The allergens in psyllium were investigated by SDS-PAGE and immunoblotting, being identified several allergenic components with an apparent molecular weight of 66, 60, 36-20 and 14 kDa. No cross-reactivity was found between P. ovata seed and P. lanceolata pollen, as determined by ELISA-inhibition. CONCLUSION: Psyllium may act as a potent inhalant allergen capable of eliciting asthma symptoms, not only in an occupational context, but also in a domestic environment, affecting consumers of this laxative or relatives who handle it.
BACKGROUND: Psyllium, a water-soluble fiber, has been shown to have a cholesterol-lowering effect in studies of adults. A small number of studies in children have produced variable results. METHODS: A 12-week, randomized, single-blind, placebo-controlled, parallel clinical trial was conducted to test the effectiveness of psyllium in lowering total (TC) and low-density lipoprotein cholesterol (LDL-C) in 50 healthy 2 to 11 year old children. Children with two baseline LDL-C levels > or = 110 mg/dL were invited to participate in the trial, and were randomly assigned to follow a usual Step I (Control) diet of low dietary fat, saturated fat and cholesterol, or a Step I diet enriched with psyllium. Children consumed two 1-oz boxes of cereal per day, with each box of psyllium-enriched cereal containing 3.2 g of soluble fiber, and each box of placebo cereal containing less than 0.5 g of soluble fiber. RESULTS: Greater reduction of total and LDL-cholesterol, and increase in HDL-cholesterol were noted after 12 weeks of the psyllium-enriched Step I diet compared to the Step I control diet. Total cholesterol decreased 21 mg/dL for the high fiber group compared with 11.5 mg/dL for the control group. LDL-C decreased 23 mg/dL for the high fiber group compared with 8.5 mg/dL for the control group. HDL-C increased 4 mg/dL for the high fiber group compared with 1 mg/dL for the controls. TC/HDL and LDL/HDL ratios decreased significantly more so for the high fiber group as well. CONCLUSIONS: In this 12-week study, soluble fiber (psyllium) provided added benefit to the Step I diet in the treatment of hypercholesterolemia.
Bulk-forming laxatives increase fecal volume and elicit aborally directed colonic motility patterns. Recently, it was demonstrated that test meals of the bulk-laxative fibers (cellulose and bran) elicited organized jejunal motor activity while nonlaxative fiber meals (guar) elicited unorganized jejunal motor activity. However, whether bulk-forming laxatives, as a class of compounds, differentially affect small intestinal motility has not been studied. Therefore, a study was made of the effects of the bulk laxatives psyllium and polycarbophil and the nonlaxative pectin on canine jejunal motor activity. Psyllium and pectin are examples of dietary fiber, while polycarbophil is a synthetic polymer. Pectin and psyllium test meals presented as viscous gels. In contrast, polycarbophil meals presented as a combination of discrete particles plus meal water. After each meal, measurements were made of the jejunal motility index, the time of reappearance of interdigestive burst activity, and overall motility patterns. Pectin and psyllium meals increased in viscosity as meal fiber content increased. As meal content and hence viscosity increased, both the laxative (psyllium) and nonlaxative (pectin) fiber meals elicited increasing jejunal motor activity and delays in the reappearance of the burst interval. For both fiber types, motor activity presented as randomly appearing contractions. In contrast, meals of the laxative polycarbophil elicited no more motor activity than the saline control meal. However, this control-level amount of activity presented as propagated clusters of contractions, ie, the "laxative-induced pattern." Polycarbophil did not delay the reappearance of burst activity.(ABSTRACT TRUNCATED AT 250 WORDS)