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Abdominal radiography in monitoring the resolution of sand accumulations from the large colon of horses treated medically.

This retrospective study consisted of 14 horses (age 6 weeks-12 years) with radiographically evident sand accumulations cranioventrally in the abdomen and clinical signs suggestive of sand enteropathy. The horses were treated medically and resolution of sand was monitored radiographically. Routine treatment consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral oilif needed. Initially, the number, size and shape of the sand accumulations showed large variation and the response to therapy was not predictable based on the initial appearance of the accumulation. In 2 foals, some of the sand was passed and the rest was mixed with other intestinal contents within 2-4 days. Even large accumulations disappeared in 2-4 days with psyllium alone or combined with mineral oil in 4 horses. In another 4 horses, the size of the accumulations decreased but varying amounts remained approximately at the same site, despite treatment for 1-4 weeks, and all these horses also had either gastric or large colon impaction. Three horses had a limited response to psyllium treatment, but the accumulation resolved with repeated doses of magnesium sulphate, with or without mineral oil. One horse did not respond to prolonged laxative treatment but the accumulation resolved on pasture. Clinical improvement was not necessarily related to the resolution of sand. Radiography of the cranioventral abdomen was found to be a useful means for monitoring the resolution of sand and confirming the effect of medical treatment in removing sand from the large colon in the horse.

Animals↗

Availability of calcium for absorption in the small intestine and colon from diets containing available and unavailable carbohydrates: an in vitro assessment.

An in vitro method simulating conditions in the small intestine and colon was used to study the effects of various carbohydrates on Ca release from basal diet (BD) containing dairy products. During enzymatic digestion of BD, 28.5 +/- 0.3% of the Ca was released. This was reduced by 3, 22 and 27% by adding bread, psyllium or pectin to BD, respectively (P < 0.05). After enzymatic digestion, the residue from BD was fermented releasing 11.9 +/- 1.2% of the Ca, a value which was significantly less than with pectin (13.7 +/- 0.9%) and greater than with psyllium (4.4 +/- 0.2%) addition. The total Ca release ranged from 26.5 +/- 0.8 to 42.2 +/- 1.0% with bread>BD>pectin>psyllium. Lactulose did not differ significantly from BD. These results suggest that carbohydrates may bind Ca and reduce its availability for absorption in the small intestine. However, if the carbohydrate is fermented, bound Ca may be released for potential absorption in the colon, whereas less fermented carbohydrates may continue to bind Ca in the colon. The in vitro method described may be useful for estimating total Ca availability. However, studies in humans are required to validate these results.

Biological Availability↗

Efficacy of a novel chitosan formulation on fecal fat excretion: a double-blind, crossover, placebo-controlled study.

The ability of a novel chitosan formulation to influence gastrointestinal fat absorption in vivo was examined in a double-blind, placebo-controlled, crossover study by determining the content of total fat in feces in two groups of subjects. Twenty-nine normal healthy subjects were recruited for the study. Twenty-four participants completed the test period with the chitosan formulation, and 21 completed the placebo phase of study. During the placebo and the test periods, the subjects were administered six capsules three times daily 10 minutes before meals for three days and for the two days of the stool collection. A daily serving of six tablets of the test compound contained 2100 mg chitosan and 300 mg psyllium husk seeds. In respect to the baseline period, the test compound increased fat excretion significantly whether the test period preceded or proceeded the placebo period (p<0.02 and p<0.05 respectively). In contrast, essentially no changes were seen during the placebo loading periods. Compared to the difference between placebo period and its baseline period, a statistically significant increase in fecal fat excretion was observed over baseline following oral supplementation of a novel formulation of chitosan and psyllium husk seeds [+3.63 gm/day +/- 0.83 (SEM) vs. -0.15 gm/day +/- 0.94 (SEM) (p=0.004)]. The average daily increase in fecal fat of 3-4 grams over control could account for a decrease in calorie consumption of 30-40 kcal per day. A total of 19 subjects completed both parts of the study. Examining the data from these 19 subjects by ANOVA, it was found that the period when the test compounds were given was statistically significantly different from the placebo baseline, placebo experimental, and test baseline periods. Using multiple comparisons, it was ascertained that the novel formulation containing chitosan plus psyllium husk seeds increases fecal fat excretion.

Adult↗

Effect of fiber supplements on the apparent absorption of pharmacological doses of riboflavin.

The effect of dietary fiber from wheat bran and psyllium gum on the apparent absorption of riboflavin was studied in 12 healthy women. The test fiber was consumed in crackers that contained approximately 7.5 gm fiber from psyllium gum, wheat bran, or a combination of the two sources. Each subject was given a riboflavin load test after consuming one of the three different fiber supplements or a control supplement that contained 1.3 gm fiber. Fractional urine collections were made for 24 hours, and riboflavin was measured by fluorometric techniques. The psyllium gum and combination supplements reduced the 24-hour apparent absorption of riboflavin from 31.8% to 25.4% and 26.1%, respectively (p less than .01). No effect of the wheat bran supplement on riboflavin was detected.

Absorption↗

The effect of dietary fiber on pancreatic amylase activity in vitro.

In vitro the influence of wheat bran, guar gum, psyllium and lignin (2.5-50 g/l) on porcine pancreatic amylase (5-10 U/ml) was investigated. Enzyme activity was decreased in the presence of these substances with the exception of lignin. The reduction depended upon fiber concentration. In bran (50 g/l) it was 92 +/- 1%, in guar gum (25 g/l) 46.3 +/- 0.6%, and in psyllium (50 g/l) 41 +/- 1.4%. The effect was partly reversible if urea (1M) was added. Variations in pH (5.8-7.8) had no influence. Glucose formation from starch catalyzed by amylase was inhibited in the presence of bran, guar gum and psyllium, suggesting that the observed effect was also of functional significance.

Amylases↗

Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus.

OBJECTIVE: We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM). DESIGN: Following an overnight fast of 8-10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken. SUBJECTS: Forty-five Type 2 DM subjects completed the requirements and were included in the study results. INTERVENTIONS: Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests. RESULTS: In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (P<0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type. CONCLUSIONS: These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal.

Adult↗

Warning: feeding animals hydrophilic fiber sources in dry diets.

Feeding animals large quantities of dry hydrophilic fiber sources, such as psyllium husk or guar gum, may lead to intestinal obstruction or to other mechanical effects unrelated to the normal function of these materials in human diets. Such fiber sources should be hydrated prior to feeding, rather than being incorporated into dry diets as is. The water-holding capacity of psyllium hydrophilic mucilloid, for example, is greater than or equal to 40 g/g, compared to 2-3 g/g of wheat bran. Consumption of the psyllium product dry would be much more likely to produce intestinal dehydration than would consumption of dry bran. Because of possible untoward effects of high levels of these materials, it may also be more appropriate to feed such fiber sources in quantities approximating that of their potential human dietary consumption, rather than very high quantities that would be unlikely to be attained in human diets.

Animal Nutritional Physiological Phenomena↗

Soluble dietary fiber and cholesterol influence in vivo hepatic and intestinal cholesterol biosynthesis in rats.

Ninety-six male Sprague-Dawley rats were randomly assigned to eight dietary treatments. Rats were fed, with ad libitum access, diets containing 10% dietary fiber as cellulose (control), pectin, psyllium or oat bran with or without 0.3% added cholesterol for 3 wk. Among cholesterol-fed rats, liver total cholesterol was significantly lower in rats fed diets supplemented with either pectin or psyllium compared with those fed cellulose. In contrast, rats fed oat bran with cholesterol had significantly higher liver cholesterol concentrations compared with cellulose-fed animals. Liver total lipid concentrations were significantly lower in groups fed pectin and psyllium with or without dietary cholesterol compared with cellulose-fed controls. Pectin feeding with or without dietary cholesterol significantly lowered plasma total cholesterol compared with cellulose feeding. Oat bran had no effect on plasma total cholesterol compared with control diets. Hepatic sterol synthesis was significantly greater for animals fed soluble dietary fibers compared with those fed cellulose, but the effect on intestinal sterol synthesis was less pronounced.

Animals↗

Changes in plasma and hepatic lipids, small intestinal histology and pancreatic enzyme activity due to aging and dietary fiber in rats.

Rats were fed either a control diet or a control diet supplemented with wheat bran, psyllium husk or oat bran to increase intake of fiber. Groups of rats were killed after 3.5, 10, 15, or 18.5 mo of consuming the diets. Plasma cholesterol and triglyceride concentrations were significantly higher in 18.5-mo-old than younger animals. Fiber supplementation did not prevent the age-related increase in lipids. Cecal weight, including contents, was higher in the psyllium husk and oat bran groups than control, and smooth muscle thickness in the ileum of psyllium husk and oat bran animals was greater than control. The score for torn villi in the small intestine was lower than expected in the wheat bran group. Amylase activity in the pancreas declined significantly with age in all groups. In aging animals fiber supplementation may enhance ileal compensation for decreases in proximal intestinal function but does not prevent age-related changes in the gut or in lipid concentrations.

Aging↗

[Occupational asthma].

OBJECTIVE: Description of three cases of work-related asthma. DESIGN: Retrospective clinical observations. SETTING: Primary care clinics in the centre of the metropolitan health area of Madrid. PATIENTS: A 19-year old male who worked in the manufacture of Psyllium and reported one month's evolution of an irritative cough on getting up in the morning. A 33-year-old male who worked as a car mechanic and reported episodes of respiratory difficulty while at work. A 17-year-old male employed by a bread manufacturer who attended because of a catarrhal condition accompanied by respiratory difficulty. MEASUREMENTS AND MAIN RESULTS: The maximum expiratory flow monitor (MEFM) was used to measure maximum expiratory flow (MEF) in two patients. The third was temporarily separated from his work environment. The monitoring of the MEF showed a slow fall of 25% in the patient who worked with Psyllium and a rapid fall of 36% in the mechanic, which coincided with the symptoms. The patient with asthma probably caused by flour evolved favourably while off work and deteriorated again on returning to work. The allergological study showed sensitivity to Psyllium, Isocyanate and flour, respectively. The three patients stayed asymptomatic on being separated from the catalysing substances. CONCLUSIONS: The early diagnosis of work-related asthma requires a high level of diagnostic awareness. It is extremely important to separate the patient from the catalysing agent. The MEFM is a very useful instrument of diagnosis for the primary care doctor.

Adolescent↗

Diet modification alters plasma HDL cholesterol concentrations but not the transport of HDL cholesteryl esters to the liver in the hamster.

These studies were undertaken to investigate the mechanism whereby diet modification alters the plasma concentration of high density lipoprotein (HDL) cholesteryl ester and apoA-I and to determine whether diet-induced alterations in circulating HDL levels are associated with changes in the rate of reverse cholesterol transport. Rates of HDL cholesteryl ester and apoA-I transport were measured in hamsters fed a control low-cholesterol, low-fat diet or the same diet supplemented with soluble fiber (psyllium) or with cholesterol and triglyceride (Western-type diet). The Western-type diet increased the plasma concentration of HDL cholesteryl ester by 46% compared to the control diet and by 86% compared to the psyllium-supplemented diet; nevertheless, the absolute rates of HDL cholesteryl ester transport to the liver were identical in the three groups. Diet-induced alterations in circulating HDL cholesteryl ester levels were due to changes in the rate of HDL cholesteryl ester entry into HDL (whole body HDL cholesteryl ester transport) and not to regulation of HDL cholesteryl ester clearance mechanisms. The Western-type diet increased the plasma concentration of HDL apoA-I by 25% compared to the control diet and by 45% relative to the psyllium-supplemented diet. Diet-induced alterations in plasma HDL apoA-I concentrations were also due entirely to changes in the rate of apoA-I entry into HDL (whole body HDL apoA-I transport). These studies demonstrate that the absolute flux of HDL cholesteryl ester to the liver, which reflects the rate of reverse cholesterol transport, remains constant under conditions in which plasma HDL cholesteryl ester concentrations are altered over a nearly 2-fold range by diet modification.

Animals↗

Effect of dietary fibre on gallstone formation in hamsters.

This study aimed at investigating the effect of different sources of dietary fibre on gallstone formation in hamsters. The substances studied were pectin, lignin and psyllium hydrocolloid. The two latter compounds protected hamsters against cholesterol gallstone formation. Lignin resulted in a decrease of the deoxycholic acid conentration and in a rise of the cholic/chenodeoxycholic acid ratio. These changes which are similar to those observed with cholestyramine suggest that lignin acts as a bile acid sequestrant. Psyllium hydrocolloid effected a similar shift of the cholic/chenodeoxycholic acid ratio but it also resulted in a rise of the deoxycholic concentration. This latter finding is not compatible with a bile acid sequestering role of this compound. The addition of alcohol to the drinking-water resulted in the formation of stones rich in pigment. Under these conditions the tendency to form such stones was not checked by either of the investigated substances.

Animals↗

Long-term use of nonsteroidal antiinflammatory drugs and other chemopreventors and risk of subsequent colorectal neoplasia.

Our objective was to study the relationship between dispensed aspirin, nonaspirin nonsteroidal antiinflammatory drugs (NSAIDs), steroidal antiinflammatory drugs (SAIDs), acetaminophen, calcium, psyllium, and multivitamin preparations and the risk for subsequent colorectal adenoma and adenocarcinoma. The design was a case-control study. The patient population was from a large municipal teaching hospital in Atlanta, Georgia. In logistic regression models, the risk of colorectal adenoma or adenocarcinoma decreased in the first two years of continuous NSAID use in a linear, time-dependent manner. The risk of colorectal neoplasia after two years of continuous NSAID use was reduced significantly (P < 0.01) as compared to nonusers. Risk reduction appeared greater for adenocarcinoma than adenoma. The use of SAIDs, calcium, multivitamins, and psyllium, as prescribed to our patient population during the mean six-year study period, conferred no measurable risk reduction. These results suggest that in prospective chemoprevention trials, a significant risk reduction can be expected after only two years of aspirin use, in doses similar to those recommended for the prevention of cardiovascular disease, or nonaspirin NSAIDs [correction of nonaspirin. NSAIDs], in doses commonly prescribed for the management of musculoskeletal pain. The results also imply that any short-term reduction in the incidence of colorectal adenoma detected in a phase II trial would underestimate the chemopreventive effect of NSAIDs on the risk of adenocarcinoma.

Adenocarcinoma↗

Determinants of decreased fecal consistency in patients with diarrhea.

BACKGROUND/AIMS: Loose stools are a common and troublesome feature in diarrhea. The purpose of this study was to investigate factors that determine different degrees of stool looseness in diarrhea. METHODS: Fecal consistency was measured visually. Stools were analyzed for content of water and solids. Water-holding capacity of insoluble solids was measured in vitro. RESULTS: Formed stools from normal subjects had a near constant ratio of water to solids despite a sevenfold variation in daily stool weight. In diarrhea, loose consistency was correlated directly with percent fecal water. For any level of percent water, steatorrhea stools were looser than nonsteatorrhea stools. Ingestion of psyllium reduced stool looseness without changing the percent water. Both the effect of fat and psyllium could be explained by consideration of the ratio of fecal water to water-holding capacity of insoluble solids. CONCLUSIONS: (1) The normal intestine delivers stools that differ widely in quantity but maintains percent fecal water within a narrow range. (2) Stool looseness in diarrhea is determined by the ratio of fecal water to water-holding capacity of insoluble solids. (3) In patients with diarrhea with normal stool weight, loose stools are due to low output of insoluble solids without the concomitant reduction in water output that occurs in normal subjects when insoluble solids are low.

Adult↗

Effects of fiber laxatives and calcium docusate on regional water content and viscosity of digesta in the large intestine of the pig.

The aim of this study was to determine how bulk fibers and calcium docusate affect regional dehydration and digesta viscosity throughout the large intestine. Fifty-two pigs were fed a chow diet supplemented with a bulk laxative, placebo, or calcium docusate for three days, after which the pigs were sacrificed and the contents of the large bowel were analyzed. Digesta occurred as a continuum from liquid (cecum, 91.2% water content) to solid (rectum, 70.5% water content). The observed 20.7% difference in water content resulted in a 240-fold increase in viscosity. Half of this water is reabsorbed in the first 18% of the large bowel length where viscosity remains relatively low. Compared to placebo, calcium docusate and calcium polycarbophil had no significant effect on digesta water content or viscosity, polycarbophil exhibited significantly (P < 0.05) lower digesta viscosity in three bowel segments, and psyllium exhibited significantly (P < 0.01) lower viscosity in six bowel segments and higher water content in nine bowel segments. In conclusion, the majority of digesta dehydration occurs early in the proximal large bowel, while the greatest increases in viscosity occur in the distal bowel. Relatively small decreases in digesta water content result in large increases in digesta viscosity. Psyllium, and to a lesser extent polycarbophil, are able to resist dehydration, resulting in a softer digesta.

Animals↗

Effects of flax fiber on laxation and glycemic response in healthy volunteers.

We investigated whether a flax supplement taken orally or baked in a bakery product would effect the physiological responses characteristic of soluble and insoluble fiber, i.e., laxation and glycemic response, respectively. In Study 1, 26 healthy young adults consumed up to 15 g of fiber from a proprietary flax fiber supplement or as a psyllium supplement for 2 weeks once usual fecal weights were established. Changes in dietary fiber intake and acceptability of both products were evaluated. An increase in fecal weight was found with both fiber treatments. Supplemental fiber at intakes of 9.0 g/day (flax) and 10.4 g/day (psyllium) gave fecal bulking capacity of about 2.9 and 4.8 g of fecal weight/g of fiber, respectively. In Study 2, the effect of flax bread versus control white bread on glycemic response was studied. Eleven fasting subjects completed four test periods (duplicate trials of each bread) under standardized glycemic testing conditions. Paired t tests were used to analyze test compared with control peak blood glucose values (6.6 +/- 0.9 mmol/L compared with 6.9 +/- 0.7 mmol/L, P < .05, respectively) and area under the curve (AUC) (669 +/- 53 compared with 693 +/- 57, P = .015, respectively). Peak blood glucose values and AUC were improved by ingestion of flax fiber in healthy subjects. In conclusion, a flax fiber supplement provides the benefits of soluble and insoluble fiber.

Adult↗

Method for the quantitation of gastric emptying time of gel test meals.

Isotopic markers were developed to allow measurement of the gastric emptying times of homogeneous and nonhomogeneous gel meals. Meals containing the dietary fibers psyllium and guar gum presented as homogeneous, viscous gels while meals containing the synthetic polymer polycarbophil presented as discrete gel particle-water mixtures. Fiber meals were labeled differently than polycarbophil meals. Fiber meals were labeled with 51Cr-CM-Sephadex. The marker was uniformly suspended in meals containing at least 1% guar or 2% psyllium. In contrast, polycarbophil particles were labeled by hydrating the dried granules with saline in which Na2(51)CrO4 had been dissolved. Use of the markers to measure gastric emptying was demonstrated in dogs fitted with duodenal cannulas. Half of the fiber meals emptied from the stomach in about 40 min without significant dilution by secretions. In contrast, only 8% of the polycarbophil particles emptied by 90 min. Particle-specific labeling of polycarbophil was important because the meal effluent was diluted extensively by secretions. We conclude that 51Cr-CM-Sephadex and soluble Cr-51 may be used as meal markers for estimation of the gastric emptying times of certain homogeneous and nonhomogeneous gel-type meals, respectively.

Acrylic Resins↗

Cholesterol-lowering effects of soluble-fiber cereals as part of a prudent diet for patients with mild to moderate hypercholesterolemia.

Soluble-fiber breakfast cereals were examined for their cholesterol-lowering ability in 58 male patients with mild to moderate hypercholesterolemia in a randomized, double-blind, placebo-controlled study. Patients followed a step 1 diet for a minimum of 6 wk, then were randomly assigned to groups incorporating either corn flakes or one of two soluble-fiber cereals (pectin enriched or psyllium enriched) in the diet for an additional 6 wk. During the diet-only phase, total cholesterol dropped 3.8%. During the cereal-plus-diet phase, total and LDL cholesterol values of the pectin-enriched cereal group dropped an additional 2.1% (P = 0.243) and 3.9% (P = 0.16), respectively, and they dropped 5.9% (P = 0.005) and 5.7% (P = 0.034), respectively, in the psyllium-enriched cereal group. During the cereal-plus-diet phase, no significant effects on HDL cholesterol, triglyceride, or body weight were found within or between any cereal groups. These results support use of soluble-fiber cereals as an effective and well-tolerated part of a prudent diet in the treatment of mild to moderate hypercholesterolemia.

Adult↗