Indications
Ispaghula seed comes from the plant Plantago ovata, also known as psyllium or isabgol. The seeds and their outer husk are a rich source of soluble fibre. It is used to relieve constipation, to soften stools in people with piles (haemorrhoids) or anal fissures, to help bulk up loose stools in some types of diarrhoea, in irritable bowel syndrome (IBS), and as a fibre supplement that can help lower cholesterol slightly.
How It Works
Ispaghula is a bulk-forming laxative. Its fibre absorbs water in the gut and swells into a soft gel. This adds bulk and moisture to the stool, making it softer and easier to pass, and helps the bowel move more regularly. The gel also binds some bile acids, which can modestly lower cholesterol. It usually starts working within 12 to 72 hours.
Dosage and Administration
Take as directed on the label. Always mix each dose in a full glass (about 150 to 200 ml) of water or juice, stir and drink straight away, then drink another glass of fluid. Do not take it dry, and do not take it just before lying down or going to bed. Drink plenty of fluids through the day.
Interactions
Ispaghula can reduce or delay the absorption of other medicines, so take other medicines at least 1 hour before or 2 hours after it. This is especially important for Digoxin, Lithium, Carbamazepine, Levothyroxine, Iron and Calcium supplements. People with diabetes using Insulin or tablets may need their dose checked, as fibre can lower blood sugar after meals.
Contraindications
- Bowel blockage or narrowing, or faecal impaction.
- Difficulty swallowing or narrowing of the food pipe.
- Sudden change in bowel habit lasting more than 2 weeks, or bleeding from the back passage, until a doctor has checked it.
- Allergy to ispaghula or psyllium.
Side Effects
Gas, bloating and a feeling of fullness are common at first and usually settle within a few days. Allergic reactions are uncommon but can occur, particularly in people who handle the powder often.
Get urgent medical help if you have chest pain, choking or difficulty swallowing or breathing after a dose, severe abdominal pain or swelling, vomiting, no bowel movement with worsening pain, or signs of a serious allergic reaction such as swelling of the face or lips.
Pregnancy and Lactation
Ispaghula is not absorbed into the body and is considered one of the safest laxatives to use during pregnancy and breastfeeding, together with plenty of fluids.
Precautions and Warnings
Taking it without enough water can cause it to swell and block the throat or bowel. Older people, people who are bedridden, and people with a narrowed bowel should use it only with medical advice. See a doctor if constipation lasts more than 1 week despite treatment. Give to children only as advised by a doctor or as directed on the label.
Overdose
Too much, especially without enough water, can cause bloating, abdominal pain and bowel blockage. Drink plenty of water and get medical help if there is severe pain, vomiting or no bowel movement.
Therapeutic Class
Bulk-forming laxative (dietary fibre).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep the container tightly closed to protect from moisture.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.