Three White Coats

Fiber Supplementation in Irritable Bowel Syndrome (IBS)

 

A recent review of 14 clinical trials investigating the use of fiber in IBS found soluble fiber, psyllium in particular, to be effective in improving IBS symptoms.

 

Psyllium is a fiber found in the husks of the Plantago ovata seed. As a soluble, partially fermentable fiber, psyllium can help in IBS in several ways:

 

•  It acts as a stool bulking agent with a laxative effect

•  SFCA produced by psyllium fermentation can reduce inflammation and have a beneficial effect on intestinal wall health

• Psyllium can act as a prebiotic, feeding and maintaining the good bacteria in the colon.

 

Fiber Supplementation for constipation relief

 

A number of clinical trials investigated the efficacy of fiber in treating constipation. The most recent systematic review of these studies found that psyllium improves stool frequency and consistency.   Evidence for other types of fiber, such as wheat bran and methylcellulose, is still lacking.

 

Fiber for glycemic control

 

Although a mixed group of materials, dietary fiber is mostly made up of carbohydrates (this is why on a food label dietary fiber is listed in that category). Unlike other carbohydrates, the ones that constitute dietary fiber are not digested in our bodies and thus do not increase blood glucose levels. However, consumption of fiber alongside digestible carbohydrates modifies the way they are processed in the body. Soluble fiber that forms gel-like substance with water slows down stomach emptying and macronutrient absorption, resulting in reduced postmeal (postprandial) glucose level as well as total and LDL (“bad”) cholesterol levels. On the other hand, insoluble fiber found in bran cereal and whole grains seems to reduce diabetes risk.

 

The results of 35 clinical studies indicate that supplementation with psyllium improves glycemic control both in diabetic and prediabetic patients.  In addition to a direct effect on the blood glucose level, psyllium can help manage prediabetes and diabetes by regulating body weight. As such, psyllium is considered a valuable addition to the lifestyle changes in diet and exercise, often recommended for diabetic and prediabetic patients.

 

Fiber Supplementation for Metabolic Syndrome

 

A number of clinical studies suggest the usefulness of psyllium supplementation in addressing several components of the metabolic syndrome.  Psyllium improves lipid profile, reduces blood glucose and regulates insulin response.

 

How to Use

 

In some people, sudden and drastic increase in fiber can lead to side effects such as cramping, bloating and gas. This can be especially uncomfortable for people with IBS, as too much fiber can lead to worsening of their symptoms. Fiber supplementation should be done carefully, slowly and in small steps. It is best to start with only half a tablespoon (or less) of fiber daily. Increase the dose gradually until you either achieve a desired effect (regulation of bowel movement, relief in IBS symptoms, meal portion control, feeling of fullness) or until you meet a recommended amount of total fiber intake (supplements plus the fiber from food).

 

In clinical trials, the most commonly used dose of psyllium was 10g per day, divided into 2 or 3 portions. Psyllium was most often consumed either immediately before or during a meal.

 

Fiber is most effective in the presence of water. Psyllium (3-5g) should be taken with a full glass of water to ease the swallowing. In addition, water or some other suitable liquid should be drank throughout the day. Excellent water substitutes are various teas that also offer health benefits, such as green (offers antioxidant properties) peppermint, chamomile (can soothe abdominal discomfort), cinnamon (may lower blood glucose). 

 

Precautions

 

The most common side effects of fiber supplementation are abdominal cramping, gas and bloating. Try lowering your dose to reduce discomfort.

 

Inhalation of psyllium powder may lead to allergic reactions in sensitive people and those with asthma. If you are using the powder, be careful when mixing it with water to avoid inhalation.

 

Just like it affects macronutrient absorption, psyllium can interfere with absorption of certain drugs. Some drugs the effectiveness of which might be diminished in interaction with psyllium include: lithium, digoxin, carbamazepine, and tricyclic antidepressants. Consult your doctor whether psyllium may be interacting with the drugs you are taking. As a general rule, take psyllium independently of any other drug, leaving 2-4 hour window in-between.

 

Taking psyllium concurrently with diabetic medications may pose a risk of hypoglycemia. Check your blood glucose levels regularly and adjust the dose if needed. 

 

Psyllium supplementation

 

Pure psyllium can be found in three forms:

 

Whole husks. Good for baking and cooking, but when mixed with liquids can form a clumpy, grainy texture that is not easy to consume.

 

• ​Organic India Organic Whole Husk Psyllium