W. Ashraf et al., EFFECTS OF PSYLLIUM THERAPY ON STOOL CHARACTERISTICS, COLON TRANSIT AND ANORECTAL FUNCTION IN CHRONIC IDIOPATHIC CONSTIPATION, Alimentary pharmacology & therapeutics, 9(6), 1995, pp. 639-647
Background: Psyllium is widely used in the symptomatic therapy of cons
tipation, Its effects on colonic function and their correlation with s
ymptomatic response have not been defined. Methods: After a 4-week bas
eline, placebo, run-in phase, 22 subjects with idiopathic constipation
confirmed by prospectively administered stool diaries were randomly a
ssigned to receive either psyllium (5 g b.d., 11 patients) or placebo
(11 patients) for 8 weeks, followed by another 4-week wash-out, placeb
o phase, A colon transit study and anorectal manometry were performed
at the beginning and at the end of each study phase, Subjects recorded
, in diaries, their daily stool frequency, difficulty with defecation
and weekly stool weight. Results: Stool frequency increased significan
tly after 8 weeks of psyllium treatment (3.8 +/- 0.4 vs. 2.9 +/- 0.1 s
tools/week, P < 0.05) as did stool weight (665.3 +/- 95.8 g vs. 405.2
+/- 75.9 g, P < 0.05). Subjects also reported an improvement in stool
consistency (stool consistency score: 3.2 +/- 0.2 vs. 3.8 +/- 0.2, P <
0.05) and pain on defecation (pain score: 2.0 +/- 0.4 vs. 2.6. +/- 0.
5, P < 0.05) on psyllium. Colon transit and anorectal manometry parame
ters were unchanged on psyllium. Subjects treated with placebo did not
show any change in either subjective or objective measures of constip
ation. Conclusions: Psyllium increases stool frequency and weight and
improves stool consistency in idiopathic constipation. These effects a
re not associated with significant changes in either colonic or rectal
motor function. We suggest that the beneficial effects of psyllium in
constipation are primarily related to a facilitation of the defecator
y process.