Psyllium - Indian

Information
Application
Notes
References

Photo: Sertürner Bildarchiv

Botanical name

Plantago ovata Forssk. (Syn. P. ispaghula Roxb.)

Family

Plantaginaceae

Common name

Blond psyllium, Isabghol, Desert Indian wheat

Information about the plant

Psyllium is native to Iran and India and is cultivated there and in neighboring countries. The genus name Plantago, derived from Latin "planta" (= foot sole) with the common suffix used for plants "-ago", refers in part to the flat, oval leaves of the plantain (P. major) lying closely on the ground in rosettes, and on the other hand to the fact that the plantain is formed by being trampled by feet.

Indian psyllium (also known as Indian psyllium plantain), however, is characterized by basal, very long, narrow-linear leaves covered in white, downy hairs. The small flowers are arranged in short, densely flowered spikes on low flower stalks, barely rising above the leaves. The fruit ripens into a dehiscent capsule and contains small, boat-shaped seeds of highly variable color. These are reminiscent of fleas, which have earned the plant the common name "Indian psyllium herb".

Medicinally used parts of plants (herbal drug)

The ripe seeds (Indian psyllium seeds—Plantaginis ovatae semen) or the seed husks (Indian psyllium husks—Plantaginis ovatae seminis tegumentum) are used. The drug is imported from Pakistan and India.

Constituents of the herbal drug

Indian psyllium seeds contain mucilage in the seed coat, proteins, and fatty oil in the endosperm.

Quality of the drug

The quality of the following drugs or drug preparations is specified in the European Pharmacopoeia (Ph. Eur):

Indian psyllium seed (Plantaginis ovatae semen)
Indian psyllium seed husks (Plantaginis ovatae seminis tegument)

Medical applications

Recognised medical use

The HMPC has accepted the internal use of psyllium for recurring constipation and softening of stools, as in painful bowel movements after rectal examinations, anal fissures, or hemorrhoids, as a "well-established medicinal use". For Indian psyllium seed husks, which have a higher swelling capacity, their use in irritable bowel syndrome and to support a cholesterol-lowering diet has also been accepted ("well established medicinal use").

Indications supported by clinical data (approval): irregular bowel movements, irritable bowel syndrome (IBS), diverticulosis, use in patients with colostomy, and as an adjunctive treatment for Crohn's disease.

ESCOP: Indian psyllium/Indian psyllium husks: for occasional constipation and when gentle bowel movements with soft stools are desired (anal fissures, hemorrhoids, following rectal or anal procedures, during pregnancy); when a high-fiber diet is required (e.g., irritable bowel syndrome); as an adjuvant in the treatment of diarrhea of various causes. Psyllium husks (additional): as an adjuvant to a low-fat diet in the treatment of mild to moderate hypercholesterolemia.

Traditional use

Not applicable.

Herbal drug preparations in finished dosage forms

Whole or crushed psyllium seed or psyllium seed husks

Dosage

Indian psyllium seeds: 8 to 40g Indian psyllium seeds (daily dose), taken in three equal doses with plenty of fluids (very important at least 200ml per dose). Indian psyllium seeds can be taken already soaked in water, milk, or juice.

Indian psyllium seed husk: Because the mucilage that swells in the seed coat has a significantly greater swelling capacity than the seeds per unit weight, just 7 to 11g of Indian psyllium seed husk are required (daily dose), taken in three equal doses with plenty of fluids (very important at least 200ml per dose).

Preparation of a tea

Not applicable.

Notes

It is essential to drink plenty of fluids when taking psyllium or psyllium husks.

Indian psyllium and Indian psyllium husks must not be taken if intestinal obstruction (ileus) is suspected, recognizable by severe abdominal pain accompanied by nausea and vomiting, or in cases of painful or bloody bowel problems, esophageal disorders, or difficulty swallowing. Additionally, psyllium seeds and psyllium husks should not be taken immediately before bedtime.

Indian psyllium or Indian psyllium husks may be used during pregnancy and lactation. Use in children under 6 years of age is not recommended due to a lack of evidence.

Side effects

Indian psyllium contains allergens that, when ingested or processed, can trigger severe allergic reactions such as a runny nose, conjunctivitis, bronchial spasms, or allergic skin reactions. Apart from that, no side effects are expected as long as adequate fluid intake is ensured. Bloating may occur in rare cases.

Interactions

Indian psyllium seed or psyllium seed husks should be taken 1/2 to 1 hour before or after taking other medicines, as they may otherwise delay the absorption of other drugs from the gastrointestinal tract.