EP.313/ Psyllium husk for Ibs and endo belly
Last week we talked about certain fruits, vegetables, beans and lentils that can boost the short chain fatty acids called propionate and acetate. Alongside butyrate, which you can increase with resistant starch rich foods such as cold oats, green bananas and cooked and cooled potatoes and rice, these guys help to lower inflammation, heal gut issues and may even protect against endo progression. To learn more about the benefits of short chain fatty acids for endo, listen to episodes 312, 311 and 310.
Today, I wanted to give you another option if you feel like a lot of the foods I listed last week just aren’t doable for you because of your bloating and IBS symptoms, or if you eat a lot of these foods already, but still suffer with gut problems and endo problems, and would like to take some extra steps to further boost these beneficial short chain fatty acids.
Today, we’re talking about psyllium husk, and the benefits of this bad boy are many.
Psyllium husk is a prebiotic soluble plant fibre and comes from the husk of seeds (for those who want to know, the plant these seeds come from is called plantago ovata, but it has many other names). You can buy it as sort of broken up husks, which is literally just called psyllium husk, or as a powder form, and you can also find it in many over the counter laxatives.
Like chia and flax seeds, psyllium husk creates a gel like gloopy texture when combined with liquid, and so it’s a great substitute for eggs in vegan baking, but also an AMAZING substitute in gluten free baking and is really the magic that makes gluten free breads, etc. work.
We’ll come back to that gel like texture shortly, because it has some amazing gut benefits, but in terms of its effects for short chain fatty acids, psyllium husk boosts acetate and propionate AND even butyrate by feeding our good gut bugs. So, if you’re struggling with the higher fermentable veggies, fruits and beans I listed last week for increasing acetate and propionate levels, then adding psyllium husk could be a more endo belly friendly way to do this. To be clear though, I am by no means suggesting you skip trying to include more veggies, beans or fruits and recommend you listen to the episode to learn how to do it in a way that is less likely to trigger symptoms! In fact, in order to get the best health outcomes from fibre, we do need to vary up our sources.
But back to psyllium, psyllium ferments at a slower pace than some other types of fermentable carbohydrates, which means that it’s less likely to trigger a quick and excessive increase in gas, which results in bloating and other IBS symptoms like cramps, or diarrhoea, etc. However, everyone has their own unique triggers, especially if small intestine bacterial overgrowth is present, so just because it’s generally deemed as better tolerated, doesn’t mean it will be, and Monash University, the creators of the Low FODMAP diet, acknowledge that psyllium husk may be one of those fibres which can exacerbate symptoms for some people, despite it being recommended for people with IBS.
Now, let’s look at the other benefits of psyllium. Psyllium is classified as a bulking type of fibre, this means that it increases volume and mass of stools, which in turn, improves consistency and form, and the extra bulk can increase the frequency of bowel movements and increase colonic transit time, which is the time it takes for food to pass through the gastrointestinal tract. This makes psyllium husk a great evidenced based option for people with constipation, and in fact, it has been studied for this purpose multiple times, hence why you will find it in prescription and over the counter laxatives.
Many people with endo suffer with constipation, and its important to resolve this problem, as oestrogen is removed daily from our bowel movements, and when we’re not having regular bowel movements, that oestrogen can be reabsorbed, resulting in excess oestrogen levels. As oestrogen is partially responsible for endo progression, we want to try and minimise any risk factors that could contribute to imbalanced oestrogen levels.
Now, what about those of us with diarrhoea or loose stools? Because it bulks up bowel movements, it can also help for those of us with runny or not well formed stools. And so you know, a healthy bowel movement in terms of stool consistency, is one that is long and snake like, with the consistency of a banana.
Additionally, psyllium husk adds thickness through its gel like texture when combined with liquids, essentially, it absorbs water in the gut. This is another way that it is able to help diarrhoea as soaking up liquid in the gut can slow down bowel motility and also of course, it helps to reduce the watery or loose bowel movements by improving consistency.
Lastly, multiple studies have shown that taking psyllium husk daily, normally before a meal, can improve blood sugar and insulin levels over time. As many of you know, keeping blood sugar levels stable is an important part of lowering the chronic inflammation we often see with endo people. Whilst today’s episode isn’t about blood sugar, I’ve linked to some further reading and listening on the topic and how it helps with endo.
The best way to know if psyllium husk is for you, is to start low and slow. Doses vary, but an average dose is up to around 14g a day, with some research suggesting higher doses, such as 20g, are more beneficial. Dr Megan Rossi, The Gut Health Doctor, recommends in her book, Eat Yourself Healthy, to start with 3g, which is about 1/2 tbsp a day, gradually building up by about 1/2 tbsp a week until you reach 3 tbsp per day. She also suggests that if you’re sensitive, to begin with 1 teaspoon, but personally, I tried 1/4 and a 1/2 tsp and I struggled with it even then, so just listen to your body and scale back if needed.
You do need to include extra water with psyllium husk, with most sources agreeing on about 25ml water per gram of psyllium. Not only does the increase in water actually allow psyllium husk to do its work and bulk and thicken stools, by drawing in water, it also prevents it causing blockages and constipation. Remember, psyllium husk absorbs water in your intestines, so if you don’t add extra water, it’s going to dry things up.
Finally, whilst the recommendations vary here, some sources suggest taking psyllium husk in divided doses. So, for example, if you were having 3 tbsp a day, you would have 1 tbsp three times a day. In our population, as we tend to have more gut reactions and sensitivities, this gradual staggering of psyllium husk could be wise. If you’re only having 1 tbsp per day, having that in one dose, providing you tolerate it, is likely going to be fine.
If you’re unsure about adding psyllium husk or you want extra guidance, speak to your doctor. As you can get psyllium husk laxatives prescribe and over the counter, they’ll most likely be open to discussing it with you.
Show notes
Blood sugar
https://pubmed.ncbi.nlm.nih.gov/26561625/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155034/
Constipation
https://pubmed.ncbi.nlm.nih.gov/30219432/
SCFA production
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358997/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735932/
Dosing
https://www.jandonline.org/article/S2212-2672(17)30225-3/fulltext
Fibre types and psyllium husk
https://www.monashfodmap.com/blog/fibre-supplements-ibs/
https://www.monashfodmap.com/blog/research-update-dietary-fibre-era-microbiome-science/
https://www.monashfodmap.com/blog/research-update-dietary-fibres-ibs/
Endo and Short Chain Fatty Acids
https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2024.1373004/full
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Produced by Chris Robson