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Indications

Ispaghula Husk (psyllium) is a fibre supplement used to relieve constipation and to keep stools soft, for example with piles (haemorrhoids), anal fissures, after surgery or during pregnancy. It is also used in irritable bowel syndrome and can help firm up loose stools. It may help lower cholesterol slightly as part of a healthy diet.

How It Works

It is a bulk-forming laxative. The husk absorbs water in the bowel and swells into a soft gel, which adds bulk to the stool, makes it softer and easier to pass, and encourages normal bowel movements.

Dosage and Administration

Adults: usually one sachet or 1 to 2 level teaspoons (about 3.5 to 7 g) once or twice a day, or as directed on the pack.

• Stir into a full glass (at least 150 ml) of water or juice and drink straight away, before it thickens.
• Drink plenty of fluids during the day.
• Do not take it lying down or just before going to bed.
• It usually works within 12 to 72 hours.
• Children: only as advised by a doctor.

Interactions

It can slow the absorption of other medicines taken at the same time, including Lithium, Carbamazepine, Digoxin, iron and calcium tablets, so take other medicines at least 1 to 2 hours before or after it. People with diabetes on insulin or tablets may need their dose adjusted because it can reduce the rise in blood sugar after meals. Do not combine with antidiarrhoeal medicines such as Loperamide unless the doctor advises.

Contraindications

• Blockage or narrowing of the bowel, or hard, impacted stool.
• Sudden change in bowel habit lasting more than 2 weeks that has not been checked by a doctor.
• Difficulty swallowing or narrowing of the food pipe.
• Allergy to ispaghula (psyllium).

Side Effects

Common: wind, bloating and mild stomach cramps, especially at the start; these usually settle within a few days. Rarely, allergic reactions, especially in people who often handle the powder.

Get urgent medical help if you have chest pain, choking, vomiting or difficulty swallowing or breathing after taking it, severe stomach pain with a swollen belly and no bowel movement, rectal bleeding, or swelling of the face or throat.

Pregnancy and Lactation

Considered safe in pregnancy and while breastfeeding, as it is not absorbed into the body. It is often a first choice for constipation in pregnancy.

Precautions and Warnings

Always take with enough water; too little fluid can cause the gel to block the throat or bowel. See a doctor if constipation lasts more than 3 days despite treatment, or if there is blood in the stool, weight loss or a lasting change in bowel habit. Older people and those with weak bowel muscles should use it under medical advice.

Overdose

Too much can cause bloating, discomfort and, if taken with too little water, bowel blockage. Drink fluids and seek 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. Close the container tightly after use.