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Randomized Controlled Trial
. 2019 Jan 20;20(2):433.
doi: 10.3390/ijms20020433.

The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls

Jonna Jalanka  1   2 , Giles Major  3 , Kathryn Murray  4 , Gulzar Singh  5 , Adam Nowak  6 , Caroline Kurtz  7 , Inmaculada Silos-Santiago  8 , Jeffrey M Johnston  9 , Willem M de Vos  10 , Robin Spiller  11
Affiliations
Randomized Controlled Trial

The Effect of Psyllium Husk on Intestinal Microbiota in Constipated Patients and Healthy Controls

Jonna Jalanka et al. Int J Mol Sci. .

Abstract

Psyllium is a widely used treatment for constipation. It traps water in the intestine increasing stool water, easing defaecation and altering the colonic environment. We aimed to assess the impact of psyllium on faecal microbiota, whose key role in gut physiology is being increasingly recognised. We performed two randomised, placebo-controlled, double-blinded trials comparing 7 days of psyllium with a placebo (maltodextrin) in 8 healthy volunteers and 16 constipated patients respectively. We measured the patients' gastrointestnal (GI) transit, faecal water content, short-chain fatty acid (SCFA) and the stool microbiota composition. While psyllium supplement had a small but significant effect on the microbial composition of healthy adults (increasing Veillonella and decreasing Subdoligranulum), in constipated subjects there were greater effects on the microbial composition (increased Lachnospira, Faecalibacterium, Phascolarctobacterium, Veillonella and Sutterella and decreased uncultured Coriobacteria and Christensenella) and alterations in the levels of acetate and propionate. We found several taxa to be associated with altered GI transit, SCFAs and faecal water content in these patients. Significant increases in three genera known to produce butyrate, Lachnospira, Roseburia and Faecalibacterium, correlated with increased faecal water. In summary, psyllium supplementation increased stool water and this was associated with significant changes in microbiota, most marked in constipated patients.

Keywords: constipation; ispaghula; microbiome; prebiotics; transit.

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Conflict of interest statement

GM: speakers fees from Allergan and Vertex. RS: research funding from research funding from LeSaffre, Norgine, Ironwood and Zespri Group Ltd. He has also acted on advisory boards for Napo Pharmaceuticals, Commonwealth International, Yuhan Corporation, Ibsen, Danone and Almirall, and received speakers’ fees from Menarini and Alfawasserman. IS-S, CK and JF: employees of Ironwood Pharmaceuticals Inc. at the time of the study. Other authors have nothing relevant to declare. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Principal co-ordinate analysis (PCoA) of the baseline microbial differences between the two study populations.
Figure 2
Figure 2
Microbial changes introduced by the psyllium supplementation to the intestinal microbiota of healthy adults.
Figure 3
Figure 3
Associations between whole gut transit time and bacterial abundance measured from all available data points: (A) relative abundance of genus Sutterella and transit time measure (weighted average position score, Weighted Average Position Score (WAPS) measure 24 h after ingestion of transit markers, smaller number indicates longer transit) in healthy subjects; (B) relative abundance of genus Sutterella and transit (WAPS) measured 48 h after ingestion of transit markers in constipated subjects.
Figure 4
Figure 4
Associations between faecal water content and intestinal genera in constipated subjects at all data points.
Figure 5
Figure 5
Significant associations between acetate and the abundance of microbial taxa in constipated patients.
Figure 6
Figure 6
Study outline. The arrows indicate faecal sample collection points.
See this image and copyright information in PMC

References

    1. Pollet A., Van Craeyveld V., Van de Wiele T., Verstraete W., Delcour J.A., Courtin C.M. In Vitro Fermentation of Arabinoxylan Oligosaccharides and Low Molecular Mass Arabinoxylans with Different Structural Properties from Wheat (Triticum aestivum L.) Bran and Psyllium (Plantago ovata Forsk) Seed Husk. J. Agric. Food Chem. 2012;60:946–954. doi: 10.1021/jf203820j. - DOI - PubMed
    1. Al-Khaldi S.F., Martin S.A., Prakash L. Fermentation of fenugreek fiber, psyllium husk, and wheat bran by Bacteroides ovatus V975. Curr. Microbiol. 1999;39:231–232. doi: 10.1007/s002849900450. - DOI - PubMed
    1. Elli M., Cattivelli D., Soldi S., Bonatti M., Morelli L. Evaluation of prebiotic potential of refined psyllium (Plantago ovata) fiber in healthy women. Pt 2J. Clin. Gastroenterol. 2008;42(Suppl. 3):S174–S176. doi: 10.1097/MCG.0b013e31817f183a. - DOI - PubMed
    1. Campbell J.M., Fahey G.C. Psyllium and methylcellulose fermentation properties in relation to insoluble and soluble fiber standards. Nutr. Res. 1997;17:619–629. doi: 10.1016/S0271-5317(97)00034-1. - DOI
    1. Mendis M., Leclerc E., Simsek S. Arabinoxylans, gut microbiota and immunity. Carbohyd. Polym. 2016;139:159–166. doi: 10.1016/j.carbpol.2015.11.068. - DOI - PubMed

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