Nutrition > Food Facts

Psyllium: Effective home remedy for bowel problems?

Dr. med. Andre Sommer

Dr. med. Andre Sommer

Psyllium seeds and psyllium husks are a popular part of the medicine chest for many. The natural product is well tolerated and can have a positive effect on digestion. In contact with water, the seeds and husks form a gel-like mucus and swell up many times over their original volume. Psyllium and their husks can not only help with diarrhea, but also with constipation.

What is special about psyllium?

The special thing about psyllium is that in contact with liquid it forms a gel-like mass that can add up to two thirds of the original weight. The mucus mainly consists of long-chain sugars (carbohydrates) and is usually very well tolerated. The husks of the psyllium form the majority of the mucus and thus swell particularly strongly. The so-called polysaccharide layer plays an important role here. This is also contained in the husks of chia seeds and flax seeds. Most of the psyllium is not digested by the body. So it acts as a natural water-soluble fiber. Among other things, psyllium is suitable as a binder for baking.

What are psyllium seeds made of?

The capsules of the plant contain about two to three millimeter long, oval, mostly yellowish to brown seeds that look a bit like fleas. Vegetable oils, proteins and iridoid glycosides are contained in the seed body of the psyllium.

The Indian psyllium (Plantago ovata) and their husks are the best known form of psyllium. The psyllium seeds available in Germany are Indian psyllium seeds (Plantago ovata, also called Plantago ispaghula) and Plantago psyllium (also called Plantago afra). Psyllium seeds belong to the family of the plantains (Latin Plantago). Psyllium is especially common in North Africa and to be found in Western Asia.

Since when have psyllium seeds been used?

Indigenous peoples already used psyllium seeds for the treatment of digestive and intestinal complaints: Psyllium was mentioned in Persian and Arabic texts over 1000 years ago. Psyllium was imported from there to India to be used as a remedy.

Where and in what form are psyllium seeds available?

Psyllium is a purely herbal remedy. In Germany, the seeds and husks of psyllium are available in online shops, pharmacies or drug stores. It is possible to buy whole seeds or only psyllium husks. The seeds and the husks are tasteless- and low in calories (100 grams of of seeds is 28 Kilocalories, 100 grams of the husks is 185 kilocalories).

How to take psyllium

The seeds or husks can be taken plain with enough liquid (two to three glasses of water or juice). Alternatively, you can you also stir them into juices or quark. The psyllium swell up quickly. During the day you should drink enough liquid. Water, tea or diluted fruit juices are suitable. Under no circumstances should psyllium be taken with milk, because milk hinders the swelling process.

Adequate intake of fluids is very important for everyone. This also applies if the psyllium is to serve to bind liquid, such as in the case of diarrhea. The reason is without sufficient fluid the seeds can stick the intestine and cause additional discomfort. Drinking at least one and a half to two liters a day is a good guide.


Important

It is not advisable to take psyllium with medication that works in the intestine. The reason is that the secreted mucus can partially absorb the medication. This reduces the amount of active ingredient in the intestine. If you are already taking other medications, you should seek advice from your doctor or pharmacist before using psyllium. Generally, psyllium should be taken three to five hours apart from other medicines.


Do psyllium seeds help with diarrhea?

Psyllium binds excess water in the intestine and thickens the stool. In addition, the consumption of psyllium or the husks regulates the emptying time of the intestine.

Psyllium seeds are helpful for these diseases:

  • Diarrhea diseases
  • Diarrhea-type irritable bowel syndrome (IBS-D)
  • Diarrhea as a symptom of inflammatory bowel disease (e.g. Crohn's disease or ulcerative colitis)

In studies, patients with diarrhea who regularly took the natural product reported fewer bowel movements per day. This demonstrably gave the sufferers more flexibility in everyday life and thus improves quality of life.

If psyllium or psyllium husks are used to treat diarrhea, you should always drink enough water: Psyllium and the husks bind excess fluid in the intestine and, in the case of diarrhea, a lot of fluid is often lost through bowel movements.

Do psyllium seeds also help with constipation?

In the even of constipation, psyllium seeds can help in two ways: After ingestion, the swollen seeds increase the volume in the intestine. This stimulates the intestine and therefore empties faster. The separated gel-like mass of the psyllium and psyllium husk also acts as a lubricant. However, it is very important to make sure that you drink enough (at least one and a half to two liters per day). If the psyllium is ingested with too little fluid, the swelling process can draw additional fluid from the stool and thus contribute to constipation instead of eliminating it.

A positive side effect of psyllium mucus in the treatment of constipation is that it can form a protective film over irritated or inflamed areas in the intestine. The mucus can also facilitate the transportation of bowel movements due to narrowing (stenosis) caused by inflammation.

What other benefits do psyllium seeds have for gut health?

Indian psyllium husk is a water-soluble fiber and is broken down by the bacteria in the large intestine. Among other things, the bacteria form short-chain fatty acids such as butyric acid, which contribute to a healthy intestinal mucosa. In addition, the mucus of the psyllium and psyllium husk binds inflammatory factors. In this way it prevents them from attacking the protective film of the intestine. In addition, the mucus reduces oxidative stress by trapping free radicals.

The laxative effect shortens the contact time of the stool with the intestinal wall and pollutants are removed faster. This is beneficial, for example, in the case of inflammatory bowel diseases such as ulcerative colitis and Crohn's disease.

Individual studies report a probiotic effect of psyllium. These studies have shown that disturbed intestinal flora can recover after taking psyllium.

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How do psyllium seeds affect blood sugar levels and blood lipids?

With diabetes and obesity, psyllium can sometimes be used in addition to medication. Studies show that the secreted mucus binds free fats in the intestine. The amount of harmful cholesterol (LDL) ingested from food is reduced. At the same time, the intake of good cholesterol (HDL) is not affected. The swollen psyllium and psyllium husks can also convey a feeling of fullness in the stomach, so that in studies patients automatically ate less food.

In the case of diabetes, a high-fiber diet helps the stabilization of blood sugar levels. Studies have shown that taking psyllium may reduce the amount of insulin needed. Patients with type 2 diabetes also benefit from the fact that psyllium can help reduce weight by reducing appetite. Weight loss could also lower blood pressure in the long term.

Although the effects of psyllium on blood lipid and blood sugar levels are generally positive, as already mentioned, taking psyllium together with other medications should always be discussed with a doctor or pharmacist.

Do psyllium seeds have side effects?

Side effects **when taking psyllium are rare and minor**. Bloating and cramps may occur in the first period of ingestion, since the body must first adjust to a high-fiber diet. However, these symptoms usually disappear after a few days.

Allergic reactions can occur when taking psyllium. This includes irritation to the lungs and trachea. If such symptoms appear, you should contact a doctor immediately. However, allergic reactions often occur during contact and inhalation of the allergens, for example when preparing the seeds and husks. In particular for workers who harvest or process psyllium, allergies can occur by inhaling the dust.

Even if you often hear otherwise: Psyllium seeds are not suitable for children and the elderly, because they can inhale the little seeds. People who are at risk of an intestinal obstruction should not use psyllium and psyllium husks.

The ability of the secreted mucus to bind substances from the intestine can also lead to drug interactions or the absorption of nutrients. Therefore, you should always discuss taking psyllium with medication in advance with a doctor or pharmacist.

When should I not consume psyllium seeds?

Those affected by an intestinal obstruction or by narrowing (strictures) of the esophagus should not use psyllium. You should consult your doctor in advance with simultaneous therapy with blood thinners (for example Marcumar) and if diabetes mellitus is difficult to adjust. Ingestion is generally not recommended for children under the age of twelve.

Can psyllium replace medications?

Psyllium cannot replace medication for inflammation in the intestine. Psyllium and their husks can only help with inflammation in addition to regular medication, but you should consult a doctor before taking psyllium. If you have diarrhea, pysyllium can be** an alternative to loperamide**.

What is the difference between psyllium and psyllium husk?

Psyllium contains a seed and a husk. In psyllium husk, the fat and protein-rich seed core is missing. The main difference is the ability to swell.

The effect of fiber such as psyllium or psyllium husk is measured by the swelling index. This number corresponds to the volume in milliliters that one gram of psyllium or husks can absorb after four hours. The swelling index of flaxseed is about six while whole psyllium is about nine. Psyllium husks, on the other hand, have a swelling index of more than 40, which compared to whole psyllium represents a much greater capacity to bind water. This causes the husks to swell more than psyllium. Due to the higher swelling index, psyllium husk also increases the amount of stool and accelerates the passage of the stool in the intestine.

How much psyllium or husk to take?

A small amount of psyllium is sufficient for a laxative or binding effect. The recommendations vary from one teaspoon up to three tablespoons a day. For a stomach-filling and cholesterol-absorbing effect, up to 25 grams per day is recommended, which corresponds to a maximum of 9 teaspoons. The husks also have a higher swelling index. That means they absorb more water than the seeds.

The dose of psyllium seed and psyllium husk is summarized in the following table. One should always follow the information on the packaging.

Trade name Name Caution with Daily dose
Psyllium seeds Flax seeds Narrowing in the esophagus and gastrointestinal tract, intestinal obstruction, drug interactions 10 to 30 grams
Plantaginis ovatae seeds Indian psyllium Narrowing in esophagus and gastrointestinal tract, bowel obstruction, diabetes difficult to control, drug interactions 12 to 40 grams
Plantaginis ovatae testa Indian psyllium husk Narrowing in the esophagus and Gastrointestinal tract, bowel obstruction, difficult to control diabetes, drug interactions 10 to 20 grams

Psyllium seeds and their husks are a good home remedy for all kinds of intestinal disorders. They act as binders against diarrhea, and they also aid digestion when constipated. But you always have to make sure that you drink enough fluid. If you are already taking other medications, you should discuss with a doctor or pharmacist whether you can use psyllium.

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Jovanovski E, Yashpal S, Komishon A, et al. Effect of psyllium (Plantago ovata) fiber on LDL cholesterol and alternative lipid targets, non-HDL cholesterol and apolipoprotein B: a systematic review and meta-analysis of randomized controlled trials. _Am J Clin Nutr. _2018;108(5):922-932.

Kumar A, Kumar N, Vij JC, Sarin SK, Anand BS. Optimum dosage of ispaghula husk in patients with irritable bowel syndrome: correlation of symptom relief with whole gut transit time and stool weight. _Good. _1987;28(2):150-155.

Markland AD, Burgio KL, Whitehead WE, et al. Loperamide Versus Psyllium Fiber for Treatment of Fecal Incontinence: The Fecal Incontinence Prescription (Rx) Management (FIRM) Randomized Clinical Trial. _Dis Colon Rectum. _2015;58(10):983-993

Mehmood MH, Aziz N, Ghayur MN, Gilani AH. Pharmacological basis for the medicinal use of psyllium husk (Ispaghula) in constipation and diarrhea. _Dig Dis Sci. _2011;56(5):1460-1471.

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Dr. med. Andre Sommer

Dr. med. Andre Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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