psyllium

1. An annual Eurasian plant (Plantago afra) having opposite leaves and small flowers borne in dense spikes.
2. The seeds of this plant, widely used as a mild bulk laxative and sometimes added to foods as a dietary source of soluble fiber.

[New Latin, from Greek psullion, diminutive of psulla, flea (from the plant's use against fleas).]

Plantago psyllium, also known as plantago or flea seed. Small, dark reddish-brown seeds which form a mucilaginous mass with water, taken medicinally to assist the passage of intestinal contents.

Brand names: Fiberall®, Konsyl®, Metamucil®, Perdiem®

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Description

Psyllium is a seed used for medicinal purposes taken from the common fleawort, Plantago psyllium. There are about 250 species of the genus Plantago found worldwide; they belong to the Plantaginaceae family. The most common species producing seed for medicinal use, in addition to P. psyllium, are P. afra, P. isphagula, P. ovata, and P. indica.

Psyllium is extensively cultivated in many parts of the world. Shrubby perennial plants with narrow green leaves put up spikes of small flowers that mature into seedpods. The seeds and husks are harvested and used in healing. The seeds are small (1.5–2 cm) and brown or reddish-brown.

Psyllium has been used in Ayurvedic medicine in India and in traditional Chinese medicine for thousands of years. It has also been used in Europe for many years, but it has become common in North American healing only near the end of the twentieth century.

General Use

Psyllium has three major uses that have been well documented by modern scientific research. These include the treatment of diarrhea, the relief of constipation,

and the lowering of serum cholesterol levels. Psyllium also has other uses in folk medicine that have not been scientifically documented.

Psyllium seed is high in dietary fiber, making it a good bulk laxative for treating chronic constipation. It is also used to soften stools and ease bowel movements after operations involving the anus and rectum, when hemorrhoids or anal fissures are present; or during pregnancy to lessen the strain of bowel movements.

Psyllium seeds are coated with a substance called mucilage that swells or "bulks up" when exposed to water. This extra volume stimulates the movement of material through the bowel. In addition, the moist, gummy mucilage lubricates the lining of the intestine. Both United States health authorities and the German Federal Health Agency's Commission E, established in 1978 to independently review and evaluate scientific literature and case studies pertaining to herb and plant medications, approve the use of psyllium to treat constipation.

Although it may at first seem contradictory, psyllium is also used to treat diarrhea and bouts of irritable bowel syndrome, a condition in which periods of diarrhea alternate with periods of constipation. As psyllium passes through the intestines, it absorbs water. This reduces the amount of fluid in the bowel and helps to control diarrhea. Both United States health authorities and the German Commission E have approved the use of psyllium to treat diarrhea.

German health authorities approved the use of psyllium to reduce serum cholesterol levels in the early 1990s, while the U. S. Food and Drug Administration (FDA) did not permit health claims to be made for psyllium content in foods until 1997. In that year, the FDA reviewed several scientific studies indicating that a daily intake of 10.2 grams of psyllium seed husk, combined with a diet low in saturated fats, consistently lowered blood cholesterol levels. A recent Canadian study confirmed the FDA's daily intake recommendation. Moreover, an improvement in the ratio of high-density lipoproteins (HDL, or "good" cholesterol) to low-density lipoproteins (LDL, or "bad" cholesterol) occurs when psyllium is used on a daily basis. The beneficial effects of psyllium on blood cholesterol levels, however, are somewhat affected by sex and age. Other surveys have found that wellness programs in which psyllium intake is one component of personalized behavioral change recommendations are more effective in lowering blood cholesterol than simply taking psyllium by itself.

In addition to these approved therapeutic uses, psyllium is used in traditional Chinese medicine to treat stomach and intestinal ulcers, heartburn, and to help manage non-insulin dependent (type 2) diabetes. One Western study showed that psyllium taken before meals reduced the rise in blood glucose that occurred after eating, suggesting a valid role for psyllium in diabetes management. Additional studies are being undertaken.

In Ayurvedic medicine, psyllium is used to cleanse the body by absorbing toxins in the large intestine so that they can be eliminated from the body. Some herbalists believe this action helps reduce the risk of colon cancer. Psyllium is also used by Ayurvedic practitioners to treat urethritis.

Preparations

Psyllium is available in a large number of over-thecounter (OTC) formulations. In the United States, it is sold in mainstream pharmacies and supermarkets under the names of Metamucil, Fiberall, and Naturacil. Many other common laxatives include psyllium as an ingredient. There has also been discussion in the United States about adding psyllium to breakfast cereals to increase their fiber content. In health food stores, psyllium can be obtained as powdered husks or seeds. A common dosage for constipation is 2 tsp of psyllium (7 g) taken with at least one glass (8 oz) of water up to three times a day. The dose for diarrhea can be even higher—up to 40 g/day.

Precautions

Psyllium is one of the safest laxatives available for long-term use. It is widely considered by the traditional medical community as very safe and effective when used in recommended doses for constipation and diarrhea.

People who are suspected of having an intestinal blockage or who suffer from narrowing of the esophagus or any other part of the intestinal tract should not use psyllium. Pregnant women, people with diabetes, and children under age six should use psyllium only after talking to their doctor. In rare cases psyllium can cause an allergic reaction.

Although such accidents are unusual, cases have been reported of patients suffocating when a mass of psyllium blocked the upper airway. Although these incidents are most common in elderly patients or those with neurological disorders, anyone taking a psyllium preparation on a regular basis should drink a large glass of water or other liquid immediately following each dose.

Side Effects

The use of psyllium may cause increased abdominal gas, stomach rumbling, and a feeling of bloating. A few patients may experience nausea and vomiting, but these side effects are rare.

Interactions

Psyllium slows the absorption from the intestine of some nutrients and may change the rate of absorption of some medications. Some nutrients that may be absorbed more slowly include zinc, calcium, iron, and vitamin B12. Carbohydrates are absorbed more slowly, which may make it necessary for insulin-dependent diabetics to adjust their insulin dose. Psyllium may also slow down or decrease the absorption of certain medications, including antibiotics, warfarin, digoxin, and nitrofurantoin. To avoid this problem, psyllium should not be taken within one hour of taking other medications. Apart from affecting speed of absorption, psyllium is not known as of 2002 to interact with any standard pharmaceuticals.

Resources

Books

Chevallier, Andrew. Encyclopedia of Medicinal Plants. Boston: DK Publishers, 1996.

Graedon, Joe and Theresa Graedon. The People's Pharmacy: Guide to Home and Herbal Remedies. New York: St. Martin's Press, 1999.

PDR for Herbal Medicines. Montvale, New Jersey: Medical Economics Company, 1998.

Peirce, Andrea. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: William Morrow and Company, 1999.

Periodicals

Hunsaker, D. M., and J. C. Hunsaker, III. "Therapy-Related Café Coronary Deaths: Two Case Reports of Rare Asphyxial Deaths in Patients Under Supervised Care." American Journal of Forensic Medicine and Pathology 23 (June 2002): 149-154.

Jenkins, D. J., C. W. Kendall, V. Vuksan, et al. "Soluble Fiber Intake at a Dose Approved by the US Food and Drug Administration for a Claim of Health Benefits: Serum Lipid Risk Factors for Cardiovascular Disease Assessed in a Randomized Controlled Crossover Trial." American Journal of Clinical Nutrition 75 (May 2002): 834-839.

Kris-Etherton, P. M., D. S. Taylor, H. Smiciklas-Wright, et al. "High-Soluble-Fiber Foods in Conjunction with a Telephone-Based, Personalized Behavior Change Support Service Result in Favorable Changes in Lipids and Lifestyles After 7 Weeks." Journal of the American Dietetic Association 102 (April 2002): 503-510.

Vega-Lopez, S., K. Conde-Knape, R. L. Vidal-Quintanar, et al. "Sex and Hormonal Status Influence the Effects of Psyllium on Lipoprotein Remodeling and Composition." Metabolism 51 (April 2002): 500-507.

Organizations

U. S. Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857. (888) 463-6332. .

[Article by: Tish Davidson; Rebecca J. Frey, PhD]

A fecal softener made from the seeds of the plants Plantago psyllium, P. indica and P. ovata. The mucilloid portion of the seeds of P. ovata is used to make psyllium hydrophilic mucilloid which is a bulk aperient to relieve constipation caused by a low residue diet.

This article is about the plant genus. For the fruit also called plantain, see Plantain.

Plantago (Plantains)
Greater Plantain (Plantago major)
Scientific classification
Kingdom:	Plantae
(unranked):	Angiosperms
(unranked):	Eudicots
(unranked):	Asterids
Order:	Lamiales
Family:	Plantaginaceae
Genus:	Plantago L.
Subgenus
There are 5 subgenera in Plantago.[citation needed] Plantago Coronopus Bougeria Psyllium Littorella

Plantago is a genus of about 200 species of small, inconspicuous plants commonly called plantains. They share this name with the very dissimilar plantain, a kind of banana. Most are herbaceous plants, though a few are subshrubs growing to 60 cm (23.5 in) tall. The leaves are sessile, but have a narrow part near the stem which is a pseudo-petiole. They have three or five parallel veins that diverge in the wider part of the leaf. Leaves are broad or narrow, depending on the species. The inflorescences are borne on stalks typically 5-40 cm (2.25-15.75 in) tall, and can be a short cone or a long spike, with numerous tiny wind-pollinated flowers.

Plantains are used as food plants by the larvae of some species of Lepidoptera (butterfly and moth) - see list of Lepidoptera that feed on plantains.

They are found all over the world, including America, Asia, Australia, New Zealand, Africa and Europe. Many species in the genus are cosmopolitan weeds. They are found in many different habitats, most commonly in wet areas like seepages or bogs. They can also be found in alpine and semi-alpine or coastal areas. The cosmopolitan weeds can be frequently seen at the side of roads.

Contents 1 Uses 2 Species 3 Gallery 4 References 5 External links

Uses

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (April 2008)

Plantago species have been used since prehistoric times as herbal remedies. The herb is astringent, anti-toxic, antimicrobial, anti-inflammatory, anti-histamine, as well as demulcent, expectorant, styptic and diuretic. Externally, a poultice of the leaves is useful for insect bites, poison-ivy rashes, minor sores, and boils. In folklore it is even claimed to be able to cure snakebite. Internally, it is used for coughs and bronchitis, as a tea, tincture, or syrup. The broad-leaved varieties are sometimes used as a leaf vegetable for salads, green sauce, et cetera.

Plantain seed husks expand and become mucilaginous when wet, especially those of P. psyllium, which is used in common over-the-counter bulk laxative and fiber supplement products such as Metamucil. P. psyllium seed is useful for constipation, irritable bowel syndrome, dietary fiber supplementation, and diverticular disease. Recent research is also showing it to be promising in lowering cholesterol and controlling diabetes. Plantain has been consumed as human food since prehistory. For example, archaeological recovery along California's Central Coast has demonstrated use of this species as a food since the Millingstone Horizon.^[1]

Psyllium supplements are typically used in powder form, along with adequate amounts of fluids. A dose of at least 7 grams daily taken with adequate amounts of fluid (water, juice) is used by some for management of elevated cholesterol. There are a number of psyllium products used for constipation. The usual dose is about 3.5 grams twice a day. Psyllium is also a component of several ready-to-eat cereals.

In India, mucilage from Desert Indianwheat (Plantago ovata) is obtained by grinding off the husk. The mucilage is sold as Isabgol, a laxative which is used to control irregular bowel syndrome and constipation. It is also used in cereals as a treatment of mild to moderate hypercholesterolemia and for reducing blood glucose. It has been used as an indigenous Ayurvedic and Unani medicine for a whole range of bowel problems.

As Old English Wegbrade the plantago is one of the nine plants invoked in the pagan Anglo-Saxon Nine Herbs Charm, recorded in the 10th century. In Romania and Bulgaria, leaves from Plantago major are used as a folk remedy to preventing infection on cuts and scratches because of its antiseptic properties. In Slovenia and other Central European regions, the leaves were traditionally used topically as a cure for blisters resulting from friction (such as caused by tight shoes etc.).

There may also be a use for plantains in the abatement of enteric methane from ruminants^[2], as the natural compounds present (e.g. condensed tannins; ~14g/kg DM), affect the acetate-propionate ratio in the rumen which is a primary mechanism by which methanogenesis is restricted^[3]. Currently this is not a viable option in any significant scale due to agronomic difficulties.

Species

The boundaries of the genus Plantago have been fairly stable, with the main question being whether to include Bougueria (one species from the Andes) and Littorella (2–3 species of aquatic plants).^[4]

There are about 200 species of Plantago, including:

Plantago afra Plantago africana Plantago aitchisonii Plantago alpina Plantago amplexicaulis Plantago arborescens Plantago arenaria - Branched Plantain Plantago argentea Plantago asiatica Plantago aucklandica Plantago bigelovii Plantago canescens Plantago coreana Plantago cordata Plantago coronopus - Buckshorn Plantain Plantago cornuti Plantago cretica Plantago cynops Plantago erecta Plantago eripoda Plantago elongata Plantago erosa Plantago fernandezia Plantago fischeri Plantago gentianoides Plantago glabrifolia

Plantago grayana Plantago hawaiiensis Plantago hedleyi Plantago heterophylla Plantago hillebrandii Plantago himalaica Plantago incisa Plantago krajinai Plantago lanceolata - Ribwort Plantain Plantago lanigera Plantago longissima Plantago macrocarpa Plantago major - Greater Plantain, Common Plantain Plantago maritima - Sea Plantain Plantago maxima Plantago media - Hoary Plantain Plantago melanochrous Plantago moorei - Moore's Plantain Plantago musicola Plantago nivalis Plantago nubicola (also known as Bougueria nubicola) Plantago obconica Plantago ovata - Blond Psyllium Plantago pachyphylla

Plantago palmata Plantago patagonica Plantago polysperma Plantago princeps Plantago pusilla Plantago psyllium - Sand Plantain, French or Dark Psyllium Plantago raoulii Plantago rapensis Plantago remota Plantago reniformis Plantago robusta Plantago rugelii - Blackseed Plantain Plantago rupicola Plantago schneideri Plantago sempervirens Plantago sparsiflora Plantago subulata Plantago spathulata Plantago tanalensis Plantago taqueti Plantago tenuiflora Plantago triandra Plantago triantha Plantago tweedyi

Gallery

Plantago alpina	Ribwort plantain (Plantago lanceolata)	Ribwort Plantain (Plantago lanceolata)	Plantago nivalis
Ribwort Plantain flower spike	Buckshorn Plantain (Plantago coronopus)	Plantago media stepposa	Plantago maritima

References

1. ^ C.Michael Hogan (2008) Morro Creek, ed. by A. Burnham
2. ^ Ramírez-Restrepo, C. and T. Barry (2005) 'Alternative temperate forages containing secondary compounds for improving sustainable productivity in grazing ruminants', Animal Feed Science and Technology, 120(3-4), 179-201.
3. ^ Lourenço, M., G. Van Ranst, B. Vlaeminck, S. De Smet, and V. Fievez (2008) 'Influence of different dietary forages on the fatty acid composition of rumen digesta as well as ruminant meat and milk', Animal Feed Science and Technology, 145(1-4), 418-437.
4. ^ Albach, D. C., Meudt, H. M. & Oxelman, B. 2005. Piecing together the "new" Plantaginaceae. American Journal of Botany 92: 297–315.

• Cho, Y.; Mower, J. P., Qiu, Y.-L. & Palmer, J. D. (2004). Mitochondrial substitution rates are extraodinarily elevated and variable in a genus of flowering plants. Proceedings of the National Academy of Science 101: 17741-17746

• Dagar, J. C.; Kumar, Y. & Tomar, O. S. (2006). Cultivation of medicinal isabgol (Plantago ovata) in alkali soils in semiarid regions of northern India. Land Degradation and Development 17: 275-283

• Rahn, K. (1996). A phylogenetic study of the Plantaginaceae. Botanical Journal of the Linnean Society 120: 145-198

• Rønsted, N.; Chase, M. W.; Albach, D. C. & Bello, M. A. (2002). Phylogenetic relationships within Plantago (Plantaginaceae): evidence from nuclear ribosomal ITS and plastid TrnL-F sequence data. Botanical Journal of the Linnean Society 139: 323-338

External links

Wikimedia Commons has media related to: Plantago

• Common Plantain, from Mrs. Grieve's herbal
• Medicinal uses of P. major in Armenia
• Additional information about psyllium, including growing procedure and economic value
• Edibility of Plantago: Visual identification and edible parts of wild plantago.

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