FOOD INTOLERANCE NETWORK FACTSHEET
Psyllium and Constipation
This factsheet is intended for people who are already following a diet that is free of additives and low in salicylates, amines and flavour enhancers (failsafe).
Keywords: psyllium, constipation, bowel health, fibre, supplements
The main causes of constipation (other than food intolerance) are:
- lack of fibre
- lack of fluid
- lack of exercise
Aim for regularity in your meals and drinks - try to eat the same amount of fibre and fluids every day, extra for exercise or hot weather
- FIBRE - eat a high fibre breakfast every day at the same time e.g. porridge, oat bran or puffed rice with psyllium sprinkled on (see fibre list below)
- HOT DRINKS - have a hot drink with your breakfast e.g. decaf or even just warm water
- ALLOW TIME for a bowel movement, some clinics recommend taking time to sit on the toilet and read the paper after breakfast to try to develop the habit
- NEVER ignore "the call to stool" - ignoring the urge when it comes can cause or aggravate constipation by weakening the signals over time
- MAINTAIN FLUIDS - drink water, soda water, spring water and decaffeinated coffee regularly throughout the day, more after exercise or when hot
- MAINTAIN FIBRE intake throughout the day, see fibre list below
- REDUCE DAIRY PRODUCTS - milk, cheese or yoghurt can be constipating due to lack of fibre - drink soymilk instead OR combine dairy products with some fibre
- EXERCISE - is great unless it makes you dehydrated, keep up the fluids while exercising
- PAINKILLERS and some other drugs are constipating. If taking e.g. paracetamol or codeine, take more fibre e.g. psyllium and water to overcome this effect.
If these rules don't help, constipation may be due to food intolerance: Do the RPAH elimination diet with challenges to pinpoint the cause of the problem e.g. salicylates
See a list below of the best foods to help with fibre including first on the list: psyllium - a supplement you can buy in supermarkets in the cereal section. You can sprinkle it on your cereal. Psyllium is very well tolerated by most failsafers but don't overdo it at first! See more information below.
Kidney beans, pears, potatoes, celery and cabbage are good failsafe sources of fibre but build up slowly. Too much can cause bloating, gas and pain.
Don't use foods with moderate or high salicylates while on the strict RPAH elimination diet.
Eggs, meat and milk are particularly constipating because they don't contain any fibre.
15.6 Lentils, cooked 1 cup
12.0 Chickpeas (garbanzos) cooked 1 cup
10.4 Beans, e.g. kidney beans, canned, plain 1 cup
8.8 100% All Bran 1/2 cup (not suitable for gluten free diet)
5.1 Pear 1 medium (failsafe; extra laxative effect due to high sorbitol content)
5.0 Oatbran, 1 cup (not suitable for gluten free diet)
4.5 Peas, boiled 1 cup (MOD glutamates)
4.5 Apple (golden or red delicious),1 large (80-100g) (MOD sals)
4.0 Oatmeal, cooked 1 cup (not suitable for gluten free diet)
4.0 Beans, green, cooked 1 cup
3.9 Corn, yellow, cooked 1 cup (HIGH sals)
3.9 Sweet potato, cooked without skin 1/2 potato (MOD sals)
3.5 Rice, brown, cooked 1 cup
3.1 Carrots, raw 1 cup (MOD sals)
2.9 Beetroot, canned, 1 cup (MOD sals)
2.3 Potato, baked, fresh 1/2 potato
1.9 Celery, raw 1 cup
1.8 Rhubarb, 2 stalks (MOD sals; extra laxative effect due to high natural anthraquinone content)
1.7 Whole grain bread 1 slice
1.6 Cabbage, raw 1 cup
1.4 Melon, cantaloupe 1 cup (HIGH sals)
1.2 Lettuce, romaine, raw 1 cup (MOD sals)
0.7 Lettuce, iceberg, raw 1 cup
0.6 White bread 1 slice
0.6 Rice, white, cooked 1/3 cup 0.6
0.0 Meat, milk, eggs
Xanthan or guar gum can be useful for regularity. If gluten free, look for a gluten free bread that contains one of these gums.
Products recommended by RPAH for constipation include Duphalac and Actilax (page 119 of the RPAH elimination diet handbook). They are made from lactulose - which is a prebiotic and therefore may promote healing.
They also recommend Movicol. One reader reported a products called Vivalax. "It’s sole ingredient is polyethylene glycol (PEG), also known as Macrogol 3350. This is the active ingredient in Movicol, however Movicol contains electrolytes (which my pharmacist said were unnecessary) and of course the salty taste may turn off some children. Cheapest from Chemist Warehouse" - thanks Susan.
Yoga exercise to relieve constipation - Uddyiana Bandha (stomach lift)
To be practiced first thing every morning on an empty stomach
1. While standing with your feet about a foot apart and your knees slightly bent, lean forwards a little from the waist and place your hands just above your knees. Inhale deeply by pushing your abdomen forwards, and then exhale by pushing your stomach in. Don't take another breath; instead, push in your stomach even more, so that it becomes hollow, and hold your breath for about ten seconds.
2. Do the same as above but, instead of holding your stomach in after exhaling, rapidly push your stomach in and out ten times without taking another breath. Stand up straight and resume normal breathing. http://www.youtube.com/watch?v=FvLKvkd09VA&feature=related
Traditional wisdom from India - yogic diet for constipation and piles
See that your diet is Sattvic (light and vegetarian), with ample servings of salads and fruit. It should have plenty of roughage by way of fiber, which helps in stool formation. Also include buttermilk in your diet but avoid curd (yoghurt), milk and milk products. Likewise avoid all confectionery products, junk / fast foods, spicy foods, alcohol and cigarettes.
Whole grains - such as bran, wholewheat, wholemeal bread and brown rice - can cause a variety of symptoms in some failsafers, from irritable bowel to behaviour. Parents are usually surprised when their children behave better on white bread. The secret with any fibre supplement is to eat it every day at the same time (or several times a day), starting with very small doses and building up slowly to avoid bloating, flatulence and diarrhoea.
Psyllium is well tolerated by failsafers and is useful as a fibre supplement especially for those on a gluten free or low wholegrain diet and also to prevent constipation.
- Psyllium is recommended by RPA e.g. plain from supermarket cereal or health food sections or plain uncoloured, unflavoured Metamucil from pharmacies.
- Psyllium is considered to be the most effective form of soluble fibre due to its high fibre content in comparison to other grains, e.g: 100 grams of psyllium provides 71 grams of soluble fibre, 100 grams of oat bran contains 5 grams of soluble fibre
- Psyllium is useful to prevent constipation, haemorrhoids and anal fissures
- Studies have shown that psyllium is useful for irritable bowel syndrome, ulcerative colitis, high blood pressure, high cholesterol, reducing blood sugar levels and inducing a feeling of fullness during weightloss diets when taken half an hour before meals.
- Psyllium can be mixed into cereals, yoghurt, soups or stews or stirred into a glass of water and consumed immediately.
- Psyllium works by absorbing fluid from the bowel to form a kind of gel, so it must be taken with plenty of fluids - the equivalent of a glass (150 ml) of water - with each dose to prevent severe and life-threatening intestinal blockage
- There have been reports of allergies in some factory workers and nurses who are frequently exposed to psyllium
- It is very important to start with small doses and build up slowly, because as with any source of high fibre (such as All-Bran) too much can cause bloating, stomach discomfort and diarrhoea if you are not used to it. Allow 2-3 days for it to take effect
- Experts warn that too much fiber may reduce the amount of calcium, iron, zinc, copper and magnesium that are absorbed from foods possibly leading to nutrient deficiencies especially in young children. Fibre may also interact with prescription medications. For these reasons, they recommend eating a variety of fibre rich foods rather than fibre supplements and stool softeners such as bran tablets, purified cellulose and powdered psyllium. Further reading: Anderson J, Perryman S, Young L, Prior S. Dietary Fiber, Colorado State University, 2011 (available here)
Adults: 2 metric tsp (5 grams) once or twice a day mixed with a glass of water
Children 8-12 years: 1 metric tsp (2.5 grams) once a day mixed with a glass of water
Children under 8: consult your dietitian
Suggested doses are from Bonvit Psyllium Husks.
This entry on www.herbwisdom.com provides more detail on psyllium and its uses.
For symptoms of food intolerance, we recommend a trial of the RPAH elimination diet - free of additives, low in salicylates, amines and flavour enhancers, and with optional removal of dairy foods and wheat or gluten, depending on severity of symptoms - preferably supervised by a dietitian. Look here http://fedup.com.au/information/support/failsafe-friendly-dietitians-and-other-health-professionals for our list of supportive dietitians.
The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians http://fedup.com.au/information/support/dietitians
© Sue Dengate updated February 2013