Psyllium Improves Symptoms of Irritable Bowel Syndrome.

Date: 9/8/2009

Source: British Medical Journal

Related Monographs: Irritable Bowel Syndrome (IBS), Psyllium Seed

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders that physicians treat. Patients with this non life-threatening condition may present with a broad range of symptoms which typically include abdominal pain associated with altered bowel habits, including constipation, diarrhea, or alternating constipation and diarrhea, and a less common presentation of painless diarrhea. Although the symptoms are typically intermittent, they may be continuous and should be present for at least three months before the diagnosis of irritable bowel syndrome is considered. People with IBS are more likely to have other discomforts such as heartburn, pain when swallowing, fatigue, chest pain (not involving the heart), and urinary-gynecological problems. IBS can mimic more serious diseases such as Crohn's disease, ulcerative colitis, colon cancer, endometriosis, and psychiatric disorders.

Psyllium is rich in dietary fiber, a common and effective treatment for constipation. While psyllium has traditionally been used as a laxative, recent research suggests that it may have applications in the treatment of high cholesterol, irritable bowel syndrome and colon inflammation. According to the Food and Drug Administration, psyllium may also help lower the risk of heart disease.

A recent randomized controlled study sought to determine the effectiveness of increasing the dietary content of soluble fiber or insoluble fiber in patients with irritable bowel syndrome. The trial included 275 patients between the ages of 18 and 65 years with IBS who were randomly assigned to one of three groups: The first received daily supplements of soluble fiber (10g psyllium), the second group received insoluble fiber (10g bran), and the third group received placebo (10g rice flour) for three months. It was found that patients assigned to receive psyllium experienced a 90 point reduction in the severity of their symptoms, which was almost double the levels observed in the placebo group. There was a reduction of 58 points in the severity of symptoms in the group assigned bran, but this group experienced a high level of early drop-out following a worsening of IBS symptoms. It appears that adding soluble fiber to the diet may improve symptoms associated with irritable bowel syndrome, but insoluble fiber may worsen the effects at least temporarily.1

1 Bijkerk CJ, de Wit NJ, Muris JWM, et al. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial. BMJ. Aug2009;339:3154.