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Int J Mol Sci. 2019 Jan 20;20(2). pii: E433. doi: 10.3390/ijms20020433.

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

Author information

1
Immunobiology Research Program and Department of Bacteriology and Immunology, Faculty of Medicine, University of Helsinki, 00014 HY Helsinki, Finland. Jonna.Jalanka@helsinki.fi.
2
Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK. Jonna.Jalanka@helsinki.fi.
3
Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK. giles.major1@nottingham.ac.uk.
4
Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK. Kathryn.Murray@nottingham.ac.uk.
5
Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK. Gulzar.Singh@nottingham.ac.uk.
6
Nottingham University Hospitals NHS Trust, the University of Nottingham, Nottinghamshire NG5 1PB, UK. adam.nowak@nhs.net.
7
Synlogic therapeutics, Cambridge, MA 02142, USA. carolinebkurtz@gmail.com.
8
Decibel Therapeutics Inc., Boston, MA 02215, USA. asilos@decibeltx.com.
9
Neurogastrx, Inc., Woburn, MA 01801, USA, formerly at Ironwood Pharmaceuticals, Cambridge, MA 02142, USA. jjohnston@neurogastrx.com.
10
Laboratory of Microbiology, Wageningen University, 6708WE Wageningen, The Netherlands. willem.devos@wur.nl.
11
Nottingham Digestive Diseases Centre and NIHR Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust, the University of Nottingham, Notts NG7 2UH, UK. Robin.Spiller@Nottingham.ac.uk.

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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