Pharmacological Basis for the Medicinal Use of Psyllium Husk (Ispaghula) in Constipation and Diarrhea

Mehmood, Malik Hassan; Aziz, Nauman; Ghayur, Muhammad Nabeel; Gilani, Anwarul Hassan

doi:10.1007/s10620-010-1466-0

Cited by 97 publications

(75 citation statements)

References 49 publications

(52 reference statements)

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“…To explore the possible mode of action, the spasmolytic potential of the extract was evaluated on spontaneously contracting isolated rabbit jejunum preparations (Mehmood et al, 2011;Janbaz et al, 2013;Khan et al, 2013). The increased free cytoplasmic Ca ++ activates the contractile elements in smooth muscle preparations, including rabbit jejunum (Karaki and Wiess, 1983).…”

Section: Discussionmentioning

confidence: 99%

“…The preparations were presumed stable when three successive responses to acetylcholine were found to be identical. The isolated rabbit jejunum preparations exhibit spontaneous rhythmic contractions on which spasmolytic activity was tested directly without using any agonist (Mehmood et al, 2011). The crude extract was added to the tissue baths in cumulative manner and the obtained response was expressed as the percent change of spontaneous contractions in rabbit jejunum recorded prior to the exposure of the test material.…”

Section: Animalsmentioning

confidence: 99%

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Pharmacological basis for the medicinal use of Rhus coriaria in hyperactive gut disorders

Janbaz

Shabbir

Mehmood

et al. 2014

Bangladesh J Pharmacol

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Section: Discussionmentioning

confidence: 99%

Section: Animalsmentioning

confidence: 99%

Pharmacological basis for the medicinal use of Rhus coriaria in hyperactive gut disorders

Janbaz

Shabbir

Mehmood

et al. 2014

Bangladesh J Pharmacol

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“…21 Psyllium seed husk has a laxative effect in low doses but, interestingly, has an antidiarrhoeal effect at higher doses. 22 The use of psyllium in small bowel cross-sectional imaging was first demonstrated by Vogel et al 23 in 1996, where psyllium was mixed with barium solution for CT enterography (CTE). Psyllium seed husk was later implemented in MRE in 2001 by Patak et al 19 Subsequent MRE and CTE studies provided conflicting results where two MRE studies found psyllium to have poor small bowel distension, 4,6 whereas two CTE studies argued that it provided good distension.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 3% sorbitolvspsyllium fibre as oral contrast agents in MR enterography

Saini

Colak

Anthwal

et al. 2014

BJR

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Objective: To compare the degree of small bowel distension achieved by 3% sorbitol, a high osmolarity solution, and a psyllium-based bulk fibre as oral contrast agents (OCAs) in MR enterography (MRE). Methods: This retrospective study was approved by our institutional review board. A total of 45 consecutive normal MRE examinations (sorbitol, n 5 20; psyllium, n 5 25) were reviewed. The patients received either 1.5 l of 3% sorbitol or 2 l of 1.6 g kg 21 psyllium prior to imaging.Quantitative small bowel distension measurements were taken in five segments: proximal jejunum, distal jejunum, proximal ileum, distal ileum and terminal ileum by two independent radiologists. Distension in these five segments was also qualitatively graded from 0 (very poor) to 4 (excellent) by two additional independent radiologists. Statistical analysis comparing the groups and assessing agreement included intraclass coefficients, Student's t-test and Mann-Whitney U-test.Results: Small bowel distension was not significantly different in any of the five small bowel segments between the use of sorbitol and psyllium as OCAs in both the qualitative (p 5 0.338-0.908) and quantitative assessments (p 5 0.083-0.856). The mean bowel distension achieved was 20.1 6 2.2 mm for sorbitol and 19.8 6 2.5 mm for psyllium (p 5 0.722). Visualization of the ileum was good or excellent in 65% of the examinations in both groups. Conclusion: Sorbitol and psyllium are not significantly different at distending the small bowel and both may be used as OCAs for MRE studies. Advances in knowledge: This is the first study to directly compare the degree of distension in MRE between these two common, readily available and inexpensive OCAs.MR enterography (MRE) is an imaging technique used to evaluate the small bowel for diagnoses that include inflammatory bowel disease and neoplasms. Sufficiently distending the small bowel with an oral contrast agent (OCA) is critical, as collapsed loops may hide or mimic abnormalities.The OCAs employed in MRE can be classified as positive, negative or biphasic contrast agents according to their signal properties on T 1 and T 2 weighted imaging. Biphasic contrast agents typically provide low signal intensity on T 1 weighted imaging and high signal intensity on T 2 weighted imaging (T2W), and are most commonly used today because of their favourable signal characteristics for detecting bowel pathology. Water is a biphasic contrast agent, but its rapid physiological absorption from the small bowel necessitates the use of additives. These additives are often highly osmolar agents or non-osmotic agents that form hydrogels that trap water molecules in the bowel lumen. Combinations of highly osmolar agents and non-osmotic agents are also frequently used, as in the case of sorbitol and locust bean gum. 1,2Ideally, the chosen contrast agent should (i) provide adequate distension of the entire small bowel, (ii) provide uniform and homogenous opacification of the lumen, (iii) provide good delineation of the bowel wall, (iv) be below cost and eas...

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“…Each tissue was allowed to equilibrate for at least 30 min before the addition of any drug and then stabilized with repeated administration of acetylcholine (Ach, 0.3 µM) at every 3-5 min interval, until similar responses were achieved. Under similar experimental conditions, guinea-pig ileum behaved as quiescent smooth muscle preparation and is considered more useful for the assessment of spasmogenic activity (Mehmood et al, 2011), while rabbit jejunum exhibits spontaneous rhythmic contractions, allowing testing the relaxant (spasmolytic) activity directly without the use of an agonist (Gilani et al, 2008;Khan et al, 2011;Rehman et al, 2013). The relaxant responses were quantified compared to the control spontaneous beating patent of isolated jejunal preparations.…”

Section: Rabbit Jejunum and Guinea-pig Ileum Preparationmentioning

confidence: 99%

Antidiarrheal and antispasmodic activities of Polygonum bistorta rhizomes are mediated predominantly through K+ channels activation

Ali

Janbaz

Mehmood

et al. 2015

Bangladesh J Pharmacol

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Polygonum bistorta is a popular medicinal herb used to treat diarrhea. This study provides pharmacological basis to its folk use in diarrhea using in vivo and in vitro assays. Administration of P. bistorta rhizomes extract to mice offered protection against castor oil-induced diarrhea at 300-1,000 mg/kg and was found safe up to the dose of 5 g/kg. In isolated rabbit jejunum, the extract caused a dose-dependent relaxation of spontaneous and low K+ (25 mM)-induced contractions with weak effect against high K+ (80 mM). In tissues pretreated with glibenclamide or tetraethylammonium chloride (TEA), the relaxant effect of the extract was markedly inhibited by TEA only. While verapamil showed complete relaxation of spontaneous, low K+, low K+ with TEA and high K+-induced contractions. In guinea-pig ileum, mild atropine-sensitive effect was observed. This study indicates that P. bistorta possesses anti-diarrheal and antispasmodic activities mediated predominantly through K+-channels activation along with weak Ca++ antagonist effect.

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Pharmacological Basis for the Medicinal Use of Psyllium Husk (Ispaghula) in Constipation and Diarrhea

Cited by 97 publications

References 49 publications

Pharmacological basis for the medicinal use of <i>Rhus coriaria</i> in hyperactive gut disorders

Pharmacological basis for the medicinal use of <i>Rhus coriaria</i> in hyperactive gut disorders

Comparison of 3% sorbitolvspsyllium fibre as oral contrast agents in MR enterography

Antidiarrheal and antispasmodic activities of <i>Polygonum bistorta</i> rhizomes are mediated predominantly through K+ channels activation

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