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PubMed1992

Effects of psyllium hydrophilic mucilloid on LDL-cholesterol and bile acid synthesis in hypercholesterolemic men.

The goal of the current study was to determine the mechanism of the hypocholesterolemic effect of psyllium using a randomized, double-blind, crossover design. Twenty males (age 44 +/- 4 yr, weight 79 +/- 10 kg) with moderate hypercholesterolemia (total 265 +/- 17 mg/dl, low density lipoprotein (LDL) 184 +/- 15 mg/dl) were studied at baseline (B) and after randomization to receive a 40-day course of 15 g/day of either psyllium (Ps) or placebo (Pl) (cellulose). After a washout period (11 +/- 2 days), subjects were crossed over to the other fiber treatment for an additional 40 days and restudied. Intestinal cholesterol absorption, cholesterol synthesis in isolated peripheral blood mononuclear cells, bile acid kinetics, gallbladder motility, and intestinal transit were measured at each study period. Psyllium lowered LDL cholesterol (x:184 (B), 169 (Ps), and 179 (Pl) mg/dl; Ps vs. B,Pl: P less than 0.004, P less than 0.02), decreased relative cholesterol absorption (x:51 (B), 45 (Ps), and 49 (Pl) %; Ps vs. B,Pl: P less than 0.03, P less than 0.03), did not alter absolute cholesterol absorption, and increased the fractional turnover of both chenodeoxycholic acid (x:0.176 (B), 0.203 (Ps), and 0.170 (Pl) day-1; Ps vs. B,Pl: P less than 0.0001, P less than 0.01) and cholic acid (x:0.303 (B), 0.411 (Ps), and 0.301 (Pl) d-1; Ps vs. B, Pl: P less than 0.006, P less than 0.002). Bile acid synthesis increased in subjects whose LDL cholesterol was lowered by more than 10% (Ps vs. B: 1304 +/- 489 vs 992 +/- 307 mumol/day, P less than 0.006; Ps vs. PI: 1304 +/- 489 vs. 914 +/- 321 mumol/day, P less than 0.0002). We conclude that psyllium lowers LDL cholesterol primarily via stimulation of bile acid synthesis.

Adult↗
PubMed1988

Comparison of the effects of psyllium and wheat bran on gastrointestinal transit time and stool characteristics.

Gastrointestinal transit time, frequency of defecation, stool weight, and stool consistency were studied in 12 subjects who were each given fiber supplements containing wheat bran, psyllium gum, a combination of wheat bran and psyllium gum, or a low-fiber control for 2 weeks. Gastrointestinal transit time was measured using four different markers: plastic pellets, chromium mordanted bran, cobalt-ethylenediamine-tetraacetic acid, and terbium oxide. The wet weight and dry weight of stools were measured, and a questionnaire accessed subjects' perceptions of the consistency of their stools. Fiber supplementation decreased transit time and increased the daily number of defecations and the wet weight and dry weight of stools. Bran had a greater effect on transit time than psyllium. Psyllium had a greater effect on the amount of water found in the stools and the total stool weight. On the days that stools were passed, 50% of the daily stool ratings were scored as "hard" when subjects received the control supplement. Less than 10% of the ratings were scored as "hard" when subjects received the high-fiber supplements. The type of marker used did not significantly affect the transit time measured.

Adult↗
PubMedDate not supplied

Determination of soluble and insoluble dietary fiber in psyllium-containing cereal products.

A method for soluble and insoluble dietary fiber determinations was developed for psyllium-containing food products, which are highly viscous in aqueous solutions. The assay is based on a modification of the AOAC soluble and insoluble dietary fiber method (991.43), which was recommended for nutrition labeling in the final U.S. food labeling regulations. We found that method 991.43 and other existing dietary fiber methods could not be applied to psyllium food products, which exhibit high viscosity in aqueous solutions, because highly viscous solutions could not be filtered easily. In this study, we modified AOAC method 991.43 to accommodate the filtration process of viscous sample solutions. Sonication followed by high-speed centrifugation was used before filtration. The principles of the method are similar to those for AOAC method 991.43, including the use of the same 3 enzymes (heat-stable alpha-amylase, protease, and amyloglucosidase) as well as similar enzyme incubation conditions. The modification using sonication and high-speed centrifugation did not alter the method performance for analytically normal products such as wheat bran, oat bran, and soy fiber. Yet, the modification allowed the separation of soluble dietary fiber fractions from insoluble fractions for psyllium products with satisfactory precision. This method for psyllium dietary fiber determinations may be applied to other food products that exhibit high viscosity in aqueous solutions.

Centrifugation↗
PubMed1994

Lipid-lowering efficacy of psyllium hydrophilic mucilloid in non insulin dependent diabetes mellitus with hyperlipidaemia.

The effect of the administration of 3.5 g of psyllium husk twice daily for 90 days was investigated in 24 patients of non insulin dependent diabetes mellitus (NIDDM) with hyperlipidaemia. After 90 days of treatment, psyllium was withdrawn and the patients were followed up for a further 90 days. Psyllium significantly decreased the levels of total cholesterol (TC; 19.7%), low-density lipoprotein cholesterol (LDL-C; 23.7%), triglycerides (TG; 27.2%) and the ratio of LDL-C to high-density lipoprotein cholesterol (HDL-C; 24.1%) and the lowering was sustained even up to 90 days after cessation of treatment. The level of HDL-C also showed a significant increase of 15.8 per cent but this effect was not sustained after cessation of treatment. The compliance was very good and no adverse effects were observed. This study indicated that psyllium husk is an effective and well tolerated adjunct to diet for the treatment of mild to moderate hyperlipidaemia in NIDDM patients.

Adult↗
PubMedDate not supplied

The cholesterol-lowering effect of a breakfast cereal containing psyllium fibre.

OBJECTIVE: To determine the cholesterol-lowering effect of ready-to-eat cereal containing soluble fibre as psyllium (86%), oatmeal and barley on the plasma lipids of otherwise healthy men with mild hypercholesterolaemia, who were already eating a diet low in saturated fats. DESIGN: Double-blind crossover trial, lasting 12 weeks, in volunteers eating each cereal for six weeks at home, in Sydney and Newcastle (New South Wales). PARTICIPANTS: Eighty-one men (average age 50 years; range, 31-69 years) who had initial plasma (total) cholesterol concentrations of 5.8-8.8 mmol/L, but did not have major illness, obesity or diabetes, and were not on special diets or taking stool bulkers. INTERVENTION: One box of cereal was eaten each day: control, 60 g wheat/wheat bran (2 g soluble fibre); or test, 50 g of product containing psyllium/oats/barley (12 g soluble fibre). Subjects were allocated at random, when established on a low saturated fat diet, to wheat followed by psyllium cereal or psyllium followed by wheat cereal. MAIN OUTCOME MEASURES: Plasma total cholesterol, high density lipoprotein cholesterol, triglyceride and low density lipoprotein cholesterol concentrations measured twice, four to seven days apart before the start of the trial and then after six weeks of eating each cereal. RESULTS: Compliance was excellent with both cereals. There were no significant differences in subjects' macronutrient intake or body weight between the two six-week periods. Total cholesterol and low density lipoprotein cholesterol concentrations fell significantly on psyllium cereal, relative to wheat cereal, in both periods at both centres (mean -3.2% and -4.4%, respectively). There were no consistent changes in triglyceride or high density lipoprotein cholesterol concentrations. CONCLUSIONS: This type of product, which is easy to consume on a daily basis, is a useful adjunct to the dietary management of mild hypercholesterolaemia.

Adult↗
PubMed1994

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

OBJECTIVE: To determine if the bulk-forming laxative, psyllium hydrophilic mucilloid (PHM), reduces the gastrointestinal side effects and enhances the cholesterol-lowering efficacy of cholestyramine resin in patients with primary hypercholesterolemia. DESIGN: After a dietary lead-in period and 6 weeks of treatment with cholestyramine, the study followed a double-blinded, placebo-controlled, crossover format. SETTING: Lipid clinic affiliated with a large metropolitan community hospital. PARTICIPANTS: Twenty-seven randomly selected male and female patients with a diagnosis of primary hypercholesterolemia. Entry criteria required a fasting low-density lipoprotein cholesterol (LDL-C) concentration of 4.91 mmol/L (190 mg/dL) or greater and a triglyceride concentration of less than 2.26 mmol/L. Patients using steroids, beta-blockers, thiazide diuretics, and lipid-lowering agents, or having a history of allergy to psyllium or aspartame were excluded. INTERVENTION: The study consisted of four interventional phases of 6 weeks' duration that included (1) dietary stabilization (National Cholesterol Education Program Step I Diet); (2) cholestyramine therapy (4 g twice daily); (3) cholestyramine with study medication (PHM [5.1 g twice daily] or placebo); and (4) cholestyramine with crossover to alternate study medication. MAIN RESULTS: Following the 6-week dietary lead-in phase, four patients were eliminated from the study because their fasting LDL-C concentrations fell below 4.14 mmol/L (160 mg/dL), and one patient was eliminated because testosterone therapy was initiated by his internist. The remaining 22 patients entered the cholestyramine treatment phase. Four left the study within 2 weeks because of intolerable gastrointestinal tract symptoms. The 18 patients who completed this phase demonstrated significant reductions in their plasma total cholesterol (7.27 vs 6.67 mmol/L [281 vs 258 mg/dL]) and LDL-C (5.38 vs 4.63 mmol/L [208 vs 179 mg/dL]) concentrations compared with baseline levels. The addition of PHM to the cholestyramine regimen provided a tendency toward further reductions in total cholesterol and LDL-C levels (6.67 vs 6.46 mmol/L [258 vs 250 mg/dL] and 4.63 vs 4.29 mmol/L [179 vs 166 mg/dL], respectively), although statistical significance was not achieved. Psyllium hydrophilic mucilloid significantly reduced the frequency and severity of constipation, abdominal discomfort, and heartburn. No reports of new gastrointestinal tract symptoms or untoward effects were noted with the addition of PHM. CONCLUSION: These data suggest that the addition of PHM to cholestyramine therapy may improve a patient's compliance by reducing the associated gastrointestinal tract side effects.

Abdominal Pain↗
PubMed1997

Constipation in Parkinson's disease: objective assessment and response to psyllium.

We evaluated the reliability of patient history and the effect of psyllium on symptoms and colorectal function in 12 patients with Parkinson's disease (PD) and constipation. In all but two, constipation anteceded the development of parkinsonian symptoms. A comparison with prospectively obtained stool diaries confirmed the patients' reported constipation in 7 of the 12 patients. Those patients with confirmed constipation had lower stool weights and reported more straining at stool. Measures of colonic and anorectal function were similar in those who were truly constipated and those who were not. Among those PD subjects with confirmed constipation, psyllium increased stool frequency and weight but did not alter colonic transit or anorectal function. We conclude that prospectively obtained stool diaries should be employed to confirm constipation in PD and that psyllium produces both subjective and objective improvements in constipation related to PD.

Aged↗
PubMed2004

Psyllium extracts decreased neoplastic phenotypes induced by the Ha-Ras oncogene transfected into a rat liver oval cell line.

Inhibition of gap junctional intercellular communication (GJIC) by tumor promoters and oncogenes has been implicated in the removal of initiated cells from the suppression of growth by neighboring cells in the tumor promoting step of carcinogenesis. The GJIC of WB-Ha-ras cell line is GJIC-deficient and they are capable of anchorage independent growth (AIG). The ethanol extract of psyllium increased GJIC 1.65-times and decreased AIG in both number and size of colonies in WB-Ha-ras cells. Histochemical staining of the gap junction protein, connexin43, showed that psyllium restored gap junction plaques on the plasma membrane of the WB-Ha-ras cells. In conclusion, the ethanol extract of psyllium reversed two tumor cell phenotypes, namely reduced GJIC and AIG, induced by the Ha-ras oncogene.

Animals↗
PubMed1994

Effect of Plantago ovata (psyllium) husk and seeds on sterol metabolism: studies in normal and ileostomy subjects.

The diet of six normal and five ileostomy subjects was supplemented with 10 g/d Plantago ovata psyllium husk for 3 wk while six normal and four ileostomy subjects received 10 g/d psyllium seed. Fecal and ileostomy output, sterol excretion, serum cholesterol, and triglycerides were measured before and after supplementation. The husk had no effect on cholesterol or triglyceride concentrations in either normal or ileostomy subjects. Total and high-density-lipoprotein-cholesterol concentrations were reduced on average by 6.4% and 9.3%, respectively, in the normal group after seed supplementation. No effect on fecal bile acid excretion in the normal subjects was found after both regimes. Ileostomy bile acids were increased (on average 25%) after seed supplementation, whereas no effect on cholesterol concentrations was found. These results suggest that psyllium seed might be more effective than the husk in reducing serum cholesterol, that this cholesterol-lowering effect is not mediated by increased fecal bile acid losses, and increased ileal losses of bile acids might be compensated for by enhanced reabsorption in the colon.

Adult↗
PubMed1982

Use of psyllium in the management of chronic nonspecific diarrhea of childhood.

The etiology and treatment of chronic nonspecific diarrhea of childhood is still poorly understood. We evaluated 23 children with this disorder in whom other etiologies of chronic diarrhea had been ruled out. The children were treated first with an unrestricted diet for 1 week, and if no response was obtained they were then treated with psyllium bulk agents for 2 weeks (1 tablespoon b.i.d.). Eighty-seven percent of the patients responded to therapy. Seven patients responded to an unrestricted diet only, and 13 responded to psyllium. Only three patients (13%) did not respond. Most children were on a restricted diet at presentation, but the amount of dietary fat intake did not correlate with the response, contrary to other reports. Treatment with normalization of the diet and psyllium bulk agents seems to be an effective mode of therapy for chronic nonspecific diarrhea of childhood.

Child, Preschool↗
PubMed1996

Effect of feeding psyllium and cholestyramine in combination on low density lipoprotein metabolism and fecal bile acid excretion in hamsters with dietary-induced hypercholesterolemia.

We wished to determine the effectiveness of submaximal doses of cholestyramine and psyllium given in combination in reversing dietary-induced hypercholesterolemia in Golden Syrian hamsters, and to investigate the mechanism or mechanisms of action through which these agents together decrease plasma low density lipoprotein cholesterol (LDL-C) levels in this model. For 30 days, male hamsters were fed a cholesterol-rich cereal-based diet containing either a submaximal dose of cholestyramine (1% wt/wt) alone or in combination with psyllium (either 2 or 4%), or a high dose of cholestyramine (3%) alone. Although the greatest cholesterol-reducing action was achieved with 3% resin alone, in the animals fed one third as much cholestyramine combined with psyllium (4%) LDL-C production decreased from 288 +/- 15 to 187 +/- 17 micrograms/h per 100 g body weight, the suppression of LDL-receptor activity was almost fully reversed, plasma LDL-C levels were reduced from 90 +/- 8 to 41 +/- 5 mg/dl, and hepatic cholesterol content decreased from 17.1 +/- 1.9 to 2.4 +/- 0.1 mg/g. In the group that received 1% resin alone, the plasma LDL-C and hepatic cholesterol levels were 60 +/- 3 mg/dl and 7.2 +/- 0.6 mg/g, respectively. As compared with animals that received 1% resin alone, those fed both agents manifested higher rates of fecal bile acid excretion and lower levels of intestinal cholesterol absorption. A significant cholesterol-lowering benefit can be derived from using these nonsystemic agents in combination at lower, more tolerable doses.

Animals↗
PubMed1983

Anaphylactic shock due to ingestion of psyllium laxative.

Psyllium, seed of Plantago ovata, is a major constituent of several bulk laxatives. There are several reports on its role as an occupational respiratory allergen. We describe a severe anaphylactic reaction caused by ingestion of psyllium laxative. The hypersensitivity to Plantago ovata was confirmed by skin testing and RAST. The possibility of hypersensitivity reaction to psyllium laxatives should be recognized and included in marketing information.

Adult↗
PubMed1991

A double-blind trial of a celandin, aloevera and psyllium laxative preparation in adult patients with constipation.

The aim of this study was to evaluate the effect of a novel laxative preparation, composed of celandin, aloevera and psyllium in patients with chronic constipation. Thirty-five men and women were randomized to receive capsules containing celandin-aloevera-psyllium, or placebo, in a double-blind trial lasting 28 days. Symptoms in the last 2 weeks of the treatment period were compared to those in the 14-day pre-trial basal period. In the celandin, aloevera and psyllium group, bowel movements became more frequent, the stools were softer and laxative dependence was reduced. In the placebo group, all these parameters were unchanged. Abdominal pain was not reduced in either group. The results of this study show that the preparation is an effective laxative in the treatment of constipation.

Adult↗
PubMed2004

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

BACKGROUND: Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy METHODS: A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was self-administered over 4 hours on the day prior to colonoscopy. A questionnaire on pre-study bowel habits and side effects was completed. Efficacy of the preparation was visually evaluated on a pre-determined scale. RESULTS: There were no significant differences between the two groups in gender, race, age, pre-study stool frequency or consistency. Tolerability was equivalent but efficacy of the bowel preparation was worse in the psyllium group compared to placebo (P < 0.05). CONCLUSIONS: In non-constipated patients psyllium based fiber supplementation should not be initiated in the few days prior to endoscopy using a polyethylene glycol preparation.

Cathartics↗
PubMed1998

Cholesterol-lowering effects of psyllium seed associated with urea metabolism.

Twenty-eight mild hypercholesterolemic male and female adults were orally administered psyllium seed for 3 months. After psyllium treatment, the serum total cholesterol, low-density-lipoprotein-cholesterol and atherogenic index significantly decreased, but levels of high-density-lipoprotein-cholesterol, triglyceride and urea nitrogen did not. To determine the parameters associated with the cholesterol-lowering effect in the subjects' backgrounds, both biochemical and hematological parameters, we statistically examined the correlation between pretreatment parameters and the absolute change of total cholesterol level. The absolute change of total cholesterol level showed a direct correlation with the triglyceride level at pretreatment (r=0.41, P=0.03) and had an inverse correlation with urea nitrogen level (r=-0.46, P=0.01) but not with the total cholesterol level (r=-0.18). The change in urea nitrogen level had an inverse correlation with the urea nitrogen level itself at pretreatment (r=-0.82, P=7 x 10[-8]) and had a direct correlation with the triglyceride level (r=0.43, P=0.02). The change in triglyceride level had an inverse correlation with the urea nitrogen level (r=-0.48, P=0.008). Furthermore, the change in total cholesterol level had direct correlations with changes in the triglyceride level (r=0.56, P=0.002) and the urea nitrogen level (r=0.51, P=0.006), but these changes in triglyceride and urea nitrogen level did not correlate significantly. These findings suggest the close association of urea nitrogen and lipid metabolism in hyperlipidemia and psyllium seed treatment.

Adult↗
PubMed1992

Delayed psyllium allergy in three nurses.

The use of psyllium has been associated with various allergic reactions. Three nurses at the Prescott Veterans Affairs Medical Center had differing degrees of psyllium allergy. The reactions ranged from sneezing to chest congestion and wheezing. Two nurses were available for skin testing, and both had a positive wheal reaction. Psyllium allergic reactions have been reported rarely in the literature; however, they may be more prevalent than previously realized.

Allergens↗
PubMed1991

Activity of psyllium hydrophilic colloid for reducing serum cholesterol in sea quail fed a diet supplemented with cholesterol.

Groups of six SEA quail were fed a 0.5% cholesterol supplemented diet to which was added 3, 6, and 10% microcrystalline cellulose (controls) or the same concentrations of psyllium hydrophilic colloid for a period of 14 days. Total serum cholesterol was measured enzymically on each animal at the end of the treatment period. Cellulose control cholesterol values averaged approximately 1500 mg/dl overall. Psyllium hydrophilic colloid had no significant effect on total serum cholesterol at either 3% or 6% in the diet but did reduce cholesterol significantly by 52% at the 10% dietary level. These results demonstrate that SEA quail appear to be less sensitive to the hypocholesterolemic action of psyllium than are chickens.

Animals↗
PubMedDate not supplied

Comparison of total costs of administering calcium polycarbophil and psyllium mucilloid in an institutional setting.

The total cost of administering calcium polycarbophil per unit dose (two tablets) was compared with that of administering psyllium mucilloid (one packet dissolved in 8 oz of water) in 20 elderly nursing-home residents. Times for printing labels, checking and initialing labels, gathering materials needed, and preparing and administering the medications were recorded during at least 50 observations in each treatment group. Total cost included nurses' and pharmacists' time, materials, and medications. Calcium polycarbophil doses were prepared and administered more quickly (mean, 49.5 sec) than psyllium mucilloid (105.3 sec). The mean cost of preparing and administering a unit dose was 28.2 for calcium polycarbophil tablets and 59.9 for psyllium mucilloid. The results suggest that the use of calcium polycarbophil tablets would save time and money in institutions in which laxatives are frequently administered.

Acrylic Resins↗