Pharmacological Basis for the Medicinal Use of Psyllium Husk (Ispaghula) in Constipation and Diarrhea
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The objective of this study was to determine the pharmacological basis of the medicinal use of psyllium husk (Ispaghula) in gastrointestinal motility disorders.
In-vivo studies were conducted on mice, and isolated rabbit jejunum and guinea-pig ileum were used in in-vitro experiments.
The crude extract of Ispaghula (Po.Cr) had a laxative effect in mice at 100 and 300 mg/kg, which was partially sensitive to atropine or SB203186 (5-HT4 antagonist). At higher doses (500 and 1,000 mg/kg), Po.Cr had antisecretory and antidiarrheal activity. In guinea-pig ileum, Po.Cr (1–10 mg/ml) had a stimulatory effect, which was partially sensitive to atropine or SB203186. In rabbit jejunum, Po.Cr had a partially atropine-sensitive stimulatory effect followed by relaxation at 10 mg/ml. The relaxation was inhibited by the presence of l-NAME, a nitric oxide (NO) synthase inhibitor, or methylene blue, a guanylyl cyclase inhibitor. Similarly, the relaxant effect of Po.Cr on K+ (80 mM)-induced contractions, was attenuated in the presence of l-NAME or methylene blue. Activity-directed fractionation of Po.Cr revealed that the gut stimulatory and inhibitory constituents were widely distributed in the aqueous and organic fractions.
This study demonstrates that Ispaghula has a gut-stimulatory effect, mediated partially by muscarinic and 5-HT4 receptor activation, which may complement the laxative effect of its fiber content, and a gut-inhibitory activity possibly mediated by blockade of Ca2+ channels and activation of NO-cyclic guanosine monophosphate pathways. This may explain its medicinal use in diarrhea. It is, perhaps, also intended by nature to offset an excessive stimulant effect.
KeywordsPlantago ovata Psyllium husk Ispaghula Spasmodic Laxative Antispasmodic Antidiarrheal
This study was funded by the Pakistan Medical Research Council. We thank Dr Graeme Cane, Head, Center of English Language, for language correction.
Conflict of interest
No competing financial interests exist.
- 8.WHO. Diarrhea: Why Children Are Still Dying and What Can Be Done?. Geneva: World Health Organization; 2009.Google Scholar
- 10.Gilani AH. Constipation and its treatment with natural drugs used in Pakistan. In: Capasso F, Mascolo N, eds. Natural Drugs and the Digestive Tract. Rome: EMSI; 1992:117–121.Google Scholar
- 11.Pasricha PJ. Treatment of disorders of bowel motility and water flux. In: Brunton LL, Lazo JS, Parker KL, eds. The Pharmacological Basis of Therapeutics. 11th ed. New York: McGraw–Hill; 2006:983–1008.Google Scholar
- 12.Duke JA, Bogenschutz-Godwin MJ, Du Celliar J, Duke PAK. Plantago ovata F. In: Hand Book of Medicinal Herbs. 2nd ed. Boca Raton: CRC Press; 2002:591–592.Google Scholar
- 13.Duke JA. Plantago ovata F. In: Handbook of Phytochemical Constituents of GRAS Herbs and Other Economic Plants. 2nd ed. Boca Raton: CRC Press; 1992:472–473.Google Scholar
- 23.Johanson JF. Review of the treatment options for chronic constipation. Med Gen Med. 2007;9:25.Google Scholar
- 31.Williamson EM, Okpako DT, Evans FJ. Pharmacological Methods in Phytotherapy Research. Chichester: Wiley; 1998:15–23.Google Scholar
- 32.Evans WC. Phytochemistry. In: Trease and Evans Pharmacognosy. 5th ed. Delhi, India: Elsevier; 2006:135–150.Google Scholar
- 33.National Research Council. Guide for the Care and Use of Laboratory Animals. Washington, DC: National Academy Press; 1996:1–7.Google Scholar
- 34.Kadowaki M, Nagakura Y, Tomoi M, Mori J, Kohsaka M. Effect of FK1052, a potent 5-hydroxytryptamine-3 and 5-hydroxytryptamine-4 receptor dual antagonist, on colonic function in vivo. J Pharmacol Exp Ther. 1993;266:274–280.Google Scholar
- 37.Godfraind T, Miller R, Wibo M. Calcium antagonism and calcium entry blockade. Pharmacol Rev. 1986;38:312–326.Google Scholar
- 42.Brown JH, Taylor P. Muscarinic receptor agonists and antagonists. In: Brunton LL, Lazo JS, Parker KL, eds. The Pharmacological Basis of Therapeutics. 11th ed. ed. New York: McGraw–Hill; 2006:183–200.Google Scholar
- 43.Sander-Bush E, Mayer SE. 5-Hydroxytryptamine (serotonin): agonist and antagonists. In: Brunton LL, Lazo JS, Parker KL, eds. The Pharmacological Basis of Therapeutics. 11th ed. New York: McGraw–Hill; 2006:297–315.Google Scholar
- 51.Al-Judaibi B, Chande N, Gregor J. Safety and efficacy of tegaserod therapy in patients with irritable bowel syndrome or chronic constipation. Can J Clin Pharmacol. 2010;17:194–200.Google Scholar
- 53.Lee CW, Sarna SK, Singaram C, Casper MA. Ca++ channel blockade by verapamil inhibits GMCs and diarrhea during small intestinal inflammation. Am J Physiol. 1997;273:785–794.Google Scholar
- 54.Billman GE. The antiarrythmic effects of the calcium antagonists. In: Epstein M, ed. Calcium Antagonists in Clinical Medicine. Philadelphia: Hanley and Belfus; 1992:183–212.Google Scholar
- 57.Ganong WF. Review of Medical Physiology. California: Appleton and Lange; 1991:263.Google Scholar
- 59.Wien R, Mason DF, Edge ND, Langston GT. The ganglion blocking properties of homologous compounds in the methonium series. Br J Pharmacol. 1952;7:534–541.Google Scholar
- 62.Mascolo N, Izzo AA, Barbato F, Capasso F. Inhibitors of nitric oxide synthetase prevent castor-oil-induced diarrhea in the rat. Br J Clin Pharmacol. 1993;108:861–864.Google Scholar
- 69.Akah PA, Oli AN, Enwerem NM, Gamaneil K. Preliminary studies on purgative effect of Carica papaya root extract. Fitoterapia. 1997;68:327–331.Google Scholar
- 70.Ramstad E. Pharmacognosy. London, New York: Blakiston Division, New York: McGraw–Hill; 1959:28–50.Google Scholar