Psyllium (Plantago ovata, Plantago isphagula)

background

Psyllium, also known as ispaghula or isphagula, comes from the seeds of Plantago ovata or Plantago ispaghula. Psyllium has a high amount of fiber and is the main ingredient in many laxatives, including Metamucil® and Serutan®.
Psyllium has been studied for its potential effects on levels of total cholesterol, LDL ("bad") cholesterol, and HDL ("good") cholesterol. Cereals that contain psyllium have appeared in the U.S. marketplace and have been promoted for their potential cholesterol and heart health benefits. Good scientific evidence also exists in support of psyllium for constipation.
Evidence of benefit for psyllium for other uses, such as diarrhea, blood pressure and blood sugar regulation, weight loss, labor induction, and other uses in the stomach and intestines, are limited or mixed. Further study is needed for these uses.
Allergic reactions, sometimes severe, have been reported. Blockage of the gastrointestinal (GI) tract has been reported, especially in people who have had bowel problems or surgery, or those who use laxatives that are not mixed with enough water.

Related Terms

AC-2, arabinose, Bran Buds® cereal, bulk laxative, butyrate, Effersyllium®, fiber, Fiberall®, Fiber-loop cereal, flea seed, fleawort, Fybogel®, Fybogel Orange®, Heartwise® cereal, hemicellulose, hexoses, Hydrocil®, Indian plantago seed, isabgol, I-so-gel®, ispaggol, ispaghula, ispaghula husk, ispaghula seed, Konsyl®, Lunelax®, Metamucil®, Minolest®, natural vegetable laxative, pale psyllium, pentoses, Perdiem®, Plantago arenaria, Plantago isphagula, Plantago ovata, Plantago ovata Forsk., Plantago ovata husks, Plantago psyllium, plantago seed, polysaccharides, prebiotic, Prodiem Plain®, psyllion, psyllios, psyllium, psyllium husk, psyllium husk powder, psyllium hydrophilic mucilloid, psyllium seed, psyllium seed husks, Psyllogel® Fibra, Regulan®, Serutan®, soluble fiber, spogel, uronic acids, Vi-Siblin®, xylose, Yerba Prima®.
Select combination products: Minolest® (16% guar gum and 62% psyllium).

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
High cholesterol (Grade: A)
Psyllium has been studied for its effects on lowering total cholesterol, LDL cholesterol, and triglyceride levels. Results are conflicting as to the effects of psyllium on HDL cholesterol levels. Findings on other effects of psyllium on inflammation are unclear at this time.
Constipation (Grade: B)
Psyllium is the main ingredient in many laxatives. Studies on the laxative effects of psyllium have been somewhat conflicting, but in general, they show that psyllium increases the wet and dry weight of stool and the frequency of bowel movements, as well as decreases total gut transit time. Fiber in general has been studied for disorders of the stomach and intestines.
Anal fissures (Grade: C)
Improvement in symptoms of anal fissure (a tear in the lining of the rectum) has been reported after taking psyllium. Early results suggest that psyllium may decrease the number of surgeries needed to heal anal fissures. More evidence is needed before conclusions can be made.
Blood pressure control (Grade: C)
Early evidence suggests that psyllium may lower blood pressure, although there are some conflicting results in people with high blood pressure. Further research in people with high blood pressure is needed before conclusions may be made.
Colon cancer (Grade: C)
Early research suggests that psyllium may reduce the risk of colon cancer and affect fiber breakdown in people with the disease. However, there are mixed results. Further study is needed to determine the effects of psyllium.
Diarrhea (Grade: C)
Psyllium has been studied for the treatment of diarrhea, especially in people who are being tube-fed. Psyllium has also been studied in combination with weight loss drugs as a possible way to reduce side effects. Available studies suggest that psyllium may help add bulk to the stools, making passage easier. More research is needed in this area.
Fat excretion in stool (Grade: C)
Early research suggests that psyllium in a combination treatment may help increase the amount of fat released in the stool. More research is needed to determine the effects of psyllium alone before conclusions can be made.
Gas (Grade: C)
Early research shows that psyllium may slow the passage of gas in the intestines. More evidence is needed before conclusions can be made.
Hemorrhoids (Grade: C)
Hemorrhoids are caused by straining and stool hardness that may occur with constipation. Early studies suggest that products containing psyllium may reduce these symptoms. More evidence is needed to confirm these results.
Hyperglycemia (high blood sugar levels) (Grade: C)
Psyllium has been studied for its effects on the blood sugar levels of both diabetics and people with healthy blood sugar levels. Although some benefits have been reported, results are mixed. Psyllium fiber has been associated with lower daily and post-meal blood sugar levels. More information is needed in this area.
Inflammatory bowel disease (Grade: C)
There is limited and unclear evidence on the effects of psyllium on disorders such as Crohn's disease and ulcerative colitis. Further research is needed before conclusions may be made.
Irritable bowel syndrome (Grade: C)
Psyllium has long been studied for its potential effects on symptoms of irritable bowel syndrome. However, results are conflicting, and further research is needed before conclusions can be made.
Kidney failure (Grade: C)
Early research suggests that psyllium lacks benefit in people who have kidney failure. Further study is needed.
Labor/birth (Grade: C)
Isaptent (DILEX-C®) is an agent that may help dilate the cervix to induce childbirth. It is made from
Weight loss (Grade: C)
Psyllium may improve blood sugar and cholesterol. Currently, a relationship between psyllium and body weight is lacking in adults and adolescents. Use of psyllium before and after eating has been shown to improve feelings of fullness and decrease food intake. However, results are conflicting. More studies are needed before a firm conclusion can be made.