‘‘I think I have to go to the toilet, and then I go out there and press and press and press, and then nothing comes anyway…Well at least no more than a small, rock-hard lump.” This is one of the experiences shared by an elderly person in a study conducted by the research unit of Denmark’s Gentofte University Hospital.
Like this person, there are many who look for a perfect laxative to get rid of their constipation.
Constipation is when a person fails to pass his stools at least thrice a week or passes with difficulty. The stool might be hard, dry, and lumpy. It is often considered a personal and not-so-discussed topic which involves one’s personal and social well-being.
People often opt for laxatives (substances that increase bowel movements) by themselves and start using them on their own.
Different types of laxatives
There are four major categories of laxatives namely
- Osmotic laxatives – Work by drawing water from the rest of your body and softening the stools, thus helping in its easy passage
- Stimulant laxatives- Work by stimulating the gut muscles to pass stools easily
- Softener laxatives- Soften the stool
- Bulk-forming laxatives- Increase the bulk or weight of the stools and stimulates bowel movements
One such bulk-forming laxative is isabgol or psyllium or ispaghula. The word isabgol originates from the Persian words “isap” and “ghol” which mean horse ear describing the shape of the seed. The seeds are enclosed in capsules that open after attaining maturity.
The seeds are milled to obtain the husk, which is hydrophilic (absorbs water) in nature and used for medicinal purposes.
Isabgol husk is an indigenous plant-based dietary fibre officially included under Indian Pharmacopoeia (IP), British Pharmacopoeia and the United States Pharmacopeia.
Isabgol is known for its rich fibre content. It has around 75-80 per cent of fibre content, of which more than 50-55 per cent are water-soluble and the rest, water insoluble.
Interestingly, among other plant sources, isabgol husk is the richest source of arabinoxylan, which is a water-soluble fibre, and forms a gel or mucilage when combined with water. This gel does not get fermented but remains intact throughout the gut.
Ayurvedic perspective of isabgol
Dr Manjunath Naik, an ayurvedic physician and nadi expert from Bengaluru’s Dheerghayush Ayurveda Clinic says that isabgol is an excellent source of fibres and is used for people with severe constipation, especially in the elderly.
He continues, “Above the age of 50, we see the predominance of vayu (the air element) which causes severe dehydration in the body. Due to this, they often suffer from constipation.”
Adding to this, Dr Gururaja MB, consultant at Dhavala Pentacare Ayurvedic Treatment Centre from Shivamogga says, “Isabgol, when soaked in water becomes slimy absorbing the water content. This sliminess increases the weight of stools, increases bowel movement and helps in easy expulsion of stools.”
Two opposite actions of isabgol
Isabgol is medically used in two extremely opposite conditions such as constipation and irritable bowel syndrome.
It is found to modify the motility of contents inside the gut by mechanical stimulation of the gut wall, thereby easing the defaecation process. This property is attributed to the gel-forming/mucilage-forming nature of its fibres.
This fibre’s non-fermentability and water-holding capacity can be effective in managing loose stools or IBS. These fibres, after reaching the gut, improve the consistency of stools thereby reducing repeated episodes of loose stools. A study conducted by researchers of Spain’s University of Leon has also found that isabgol husk has a protective action on the intestinal mucosa (inner lining of intestines). This anti-ulcerogenic activity promotes the healing process.
When and how to consume it
Dr Gururaja says that there is the possibility of reduced absorption of nutrients if isabgol is consumed immediately after food intake. Thus, it is always safe to consume it at least two hours post dinner and before going to bed.
“The dosage and duration should be decided by the physician,” says Dr Naik.
Nandini Agarwal, a nutritionist from Jaipur is of the same opinion. The action of this husk varies as per the medium with which it is consumed. Agarwal says that when consumed with hot water, it eases the motions and when used with curd it has the opposite action.
Adequate hydration is important while consuming isabgol
One should maintain their hydration levels as it is hygroscopic (absorbs water) in nature. There is the possibility that it can dehydrate the body and be troublesome to the gut. It should be consumed with a minimum of 150 ml of water or other media (curd, buttermilk) to avoid blockage in the oesophagus or throat.
Who can consume
Although it is claimed to be safe for everyone, experts say that pregnant and breastfeeding mothers, and children need to seek their physician’s guidance. Elderly people with habitual constipation can consume this.
Youngsters who have constipation can adopt other methods as well to solve the issue. Dr Manjunath recommends proper chewing of food, eating staple foods, including enough fruits and vegetables in the diet, adequate hydration and moderate exercises for those with constipation.
Adding to this, Agarwal says that isabgol can be very useful when we travel frequently, and do not consume sufficient whole grains and vegetables. It can be used to avoid constipation and digestive issues.
Possible side effects
Agarwal says that anything in excess is bad and recommends an expert’s help instead of overdoing it without proper knowledge of dosage and duration.
- Rare possibility of allergies
- Discomfort and flatulence
- Risk of intestinal obstruction if not hydrated adequately
- Can interfere with the absorption of other medicines and nutrients
A study has found that 25g isabgol husk increases the excretion of essential trace minerals like zinc, copper and manganese.
Who cannot use this
- People having irregular bowel habits for more than two weeks
- People who fail to defaecate even with the use of a laxative
- Undiagnosed health conditions related to gastrointestinal tract
- Rectal bleeding
- Abdominal blockages due to underlying illnesses such as paralysis of the ileus, intestine, or large intestines
- Constrictions of the oesophagus
- People with diagnosed hypersensitivity (allergy) to isabgol
- Those with faecal impaction (a condition where a hard mass of stool is stuck in the intestines and causes severe pain)
Other medicinal benefits of isabgol
- Regularising elevated blood glucose levels in Type II Diabetes Mellitus
- Reducing high cholesterol levels
- Effectively managing duodenal ulcer
Wooow Dr. Chetana its an amazing article
Thanks Dr. Chetana. It’s very informative.
What all medicine can I take?