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1.
BMC Vet Res ; 17(1): 100, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653329

RESUMO

BACKGROUND: Chronic intermittent or persistent diarrhoea is a common condition in dogs and may be a reflex of gastrointestinal or non-gastrointestinal disorders. Besides diarrhoea, many athletes experience other gastrointestinal symptoms. Dietary fiber can help normalize colonic motility and transit time, support normal gastrointestinal microflora growth and provide fuel for colonocytes. This study aimed to evaluate dietary supplementation effectiveness with psyllium husk in police working dogs with chronic large-bowel diarrhoea. Twenty-two animals were selected. Concurrent conditions were ruled out through complete blood count and serum biochemistry. Fecal Clostridium and Salmonella were also screened. A soluble fiber, psyllium husk, was added to the diet at the dose of 4 tablespoons/day for 1 month. A daily log of fecal characteristics (type, frequency, and color) was maintained during the supplementation month and for an additional month, without supplementation. RESULTS: Response to treatment was classified as "very good" in 50% of animals, "good" in 40% of animals, and "poor" in 10% of cases. During the month of psyllium husk supplementation, defecation frequency decreased from 3.5 to 2.9 times a day, with 90% of animals showing consistent stools regularly and registering a mean increase of 2 kg in body weight. Beneficial effects were still observed during the second month, without psyllium husk supplementation. CONCLUSION: Psyllium husk can be useful in the management of chronic large-bowel diarrhoea in working dogs, which exhibited lower defecation frequency, improved stool consistency, and gained weight. Effects were felt beyond the supplementation period. Alternative approaches for non-responsive cases need to be evaluated.


Assuntos
Diarreia/veterinária , Doenças do Cão/tratamento farmacológico , Psyllium/uso terapêutico , Cães Trabalhadores , Animais , Diarreia/tratamento farmacológico , Cães , Fezes , Feminino , Masculino , Psyllium/administração & dosagem , Resultado do Tratamento
2.
Crit Rev Food Sci Nutr ; 60(5): 859-872, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30880409

RESUMO

Background: Previous studies reported inconsistent findings regarding the effects of psyllium supplementation on obesity measures. This systematic review and meta-analysis was performed to summarize data from available randomized clinical trials (RCTs) on the effect of psyllium supplementation on body weight, body mass index (BMI), and waist circumference (WC) in adults.Methods: PubMed, SCOPUS, Cochrane Library, and Google Scholar were searched to identify relevant articles up to August 2018. The effect sizes were presented as weighted mean difference (WMD) and 95% confidence intervals (CI) by using random effects model. To detect dose-response relationships, we used fractional polynomial modeling.Results: A total of 22 RCTs were included. Meta-analysis did not find any significant effect of psyllium supplementation on body weight (MD: -0.28 kg, 95% CI: -0.78, 0.21, p = 0.268), BMI (MD: -0.19 kg/m2, 95% CI: -0.55, 0.15, p = 0.27) and WC (MD: -1.2 cm, 95% CI: -2.6, 0.2, p = 0.09). Subgroup analysis showed that psyllium dosage, kind of psyllium administration, duration of trial, study design, sample size, and gender were potential sources of heterogeneity. Moreover, there was nonlinear association between duration of psyllium consumption, BMI and WC.Conclusion: Psyllium supplementation does not reduce body weight, BMI, and WC significantly.


Assuntos
Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Suplementos Nutricionais , Psyllium/farmacologia , Circunferência da Cintura/efeitos dos fármacos , Adulto , Relação Dose-Resposta a Droga , Humanos , Psyllium/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Gastroenterology ; 154(4): 1037-1046.e2, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29174952

RESUMO

BACKGROUND & AIMS: It is not clear how the complex interactions between diet and the intestinal microbiota affect development of mucosal inflammation or inflammatory bowel disease. We investigated interactions between dietary ingredients, nutrients, and the microbiota in specific pathogen-free (SPF) and germ-free (GF) mice given more than 40 unique diets; we quantified individual and synergistic effects of dietary macronutrients and the microbiota on intestinal health and development of colitis. METHODS: C56BL/6J SPF and GF mice were placed on custom diets containing different concentrations and sources of protein, fat, digestible carbohydrates, and indigestible carbohydrates (fiber). After 1 week, SPF and GF mice were given dextran sulfate sodium (DSS) to induce colitis. Disease severity was determined based on the percent weight change from baseline, and modeled as a function of the concentration of each macronutrient in the diet. In unchallenged mice, we measured intestinal permeability by feeding mice labeled dextran and measuring levels in blood. Feces were collected and microbiota were analyzed by 16S rDNA sequencing. We collected colons from mice and performed transcriptome analyses. RESULTS: Fecal microbiota varied with diet; the concentration of protein and fiber had the strongest effect on colitis development. Among 9 fiber sources tested, psyllium, pectin, and cellulose fiber reduced the severity of colitis in SPF mice, whereas methylcellulose increased severity. Increasing dietary protein increased the density of the fecal microbiota and the severity of colitis in SPF mice, but not in GF mice or mice given antibiotics. Psyllium fiber reduced the severity of colitis through microbiota-dependent and microbiota-independent mechanisms. Combinatorial perturbations to dietary casein protein and psyllium fiber in parallel accounted for most variation in gut microbial density and intestinal permeability in unchallenged mice, as well as the severity of DSS-induced colitis; changes in 1 ingredient could be offset by changes in another. CONCLUSIONS: In an analysis of the effects of different dietary components and the gut microbiota on mice with and without DSS-induced colitis, we found complex mixtures of nutrients affect intestinal permeability, gut microbial density, and development of intestinal inflammation.


Assuntos
Bactérias/crescimento & desenvolvimento , Colite/microbiologia , Colo/microbiologia , Dieta , Microbioma Gastrointestinal , Ração Animal , Animais , Bactérias/classificação , Bactérias/isolamento & purificação , Caseínas/administração & dosagem , Colite/metabolismo , Colite/fisiopatologia , Colite/prevenção & controle , Colo/metabolismo , Colo/fisiopatologia , Sulfato de Dextrana , Dieta/efeitos adversos , Fibras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Modelos Animais de Doenças , Fezes/microbiologia , Feminino , Proteínas de Homeodomínio/genética , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Estado Nutricional , Valor Nutritivo , Permeabilidade , Psyllium/administração & dosagem , Índice de Gravidade de Doença , Fatores de Tempo
4.
Int J Mol Sci ; 20(2)2019 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-30669509

RESUMO

Psyllium is a widely used treatment for constipation. It traps water in the intestine increasing stool water, easing defaecation and altering the colonic environment. We aimed to assess the impact of psyllium on faecal microbiota, whose key role in gut physiology is being increasingly recognised. We performed two randomised, placebo-controlled, double-blinded trials comparing 7 days of psyllium with a placebo (maltodextrin) in 8 healthy volunteers and 16 constipated patients respectively. We measured the patients' gastrointestnal (GI) transit, faecal water content, short-chain fatty acid (SCFA) and the stool microbiota composition. While psyllium supplement had a small but significant effect on the microbial composition of healthy adults (increasing Veillonella and decreasing Subdoligranulum), in constipated subjects there were greater effects on the microbial composition (increased Lachnospira, Faecalibacterium, Phascolarctobacterium, Veillonella and Sutterella and decreased uncultured Coriobacteria and Christensenella) and alterations in the levels of acetate and propionate. We found several taxa to be associated with altered GI transit, SCFAs and faecal water content in these patients. Significant increases in three genera known to produce butyrate, Lachnospira, Roseburia and Faecalibacterium, correlated with increased faecal water. In summary, psyllium supplementation increased stool water and this was associated with significant changes in microbiota, most marked in constipated patients.


Assuntos
Bactérias/classificação , Constipação Intestinal/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Psyllium/administração & dosagem , Adulto , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Estudos de Casos e Controles , Constipação Intestinal/metabolismo , Constipação Intestinal/microbiologia , Método Duplo-Cego , Ácidos Graxos Voláteis/análise , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Filogenia , Psyllium/farmacologia , Adulto Jovem
5.
Exp Physiol ; 103(10): 1302-1308, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30070742

RESUMO

NEW FINDINGS: What is the central question of this study? How do gastric stretch and gastric cooling stimuli affect cardiac autonomic control? What is the main finding and its importance? Gastric stretch causes an increase in cardiac sympathetic activity. Stretch combined with cold stimulation result in an elimination of the sympathetic response to stretch and an increase in cardiac parasympathetic activity, in turn resulting in a reduction in heart rate. Gastric cold stimulation causes a shift in sympathovagal balance towards parasympathetic dominance. The cold-induced bradycardia has the potential to decrease cardiac workload, which might be significant in individuals with cardiovascular pathologies. ABSTRACT: Gastric distension increases blood pressure and heart rate in young, healthy humans, but little is known about the effect of gastric stretch combined with cooling. We used a randomized crossover study to assess the cardiovascular responses to drinking 300 ml of ispaghula husk solution at either 6 or 37°C in nine healthy humans (age 24.08 ± 9.36 years) to establish the effect of gastric stretch with and without cooling. The effect of consuming peppermint oil capsules to activate cold thermoreceptors was also investigated. The ECG, respiratory movements and continuous blood pressure were recorded during a 5 min baseline period, followed by a 115 min post-drink period, during which 5 min epochs of data were recorded. Cardiac autonomic activity was assessed using time and frequency domain analyses of respiratory sinus arrhythmia to quantify parasympathetic autonomic activity, and corrected QT (QTc) interval analysis to quantify sympathetic autonomic activity. Gastric stretch only caused a significant reduction in QTc interval lasting up to 15 min, with a concomitant but non-significant increase in heart rate, indicating an increased sympathetic cardiac tone. The additional effect of gastric cold stimulation was significantly to reduce heart rate for up to 15 min, elevate indicators of cardiac parasympathetic tone and eliminate the reduction in QTc interval seen with gastric stretch only. Stimulation of gastric cold thermoreceptors with menthol also caused a significant reduction in heart rate and concomitant increase in the root mean square of successive differences. These findings indicate that gastric cold stimulation causes a shift in the sympathovagal balance of cardiac control towards a more parasympathetic dominant pattern.


Assuntos
Frequência Cardíaca/efeitos dos fármacos , Coração/efeitos dos fármacos , Mentol/administração & dosagem , Adulto , Sistema Nervoso Autônomo/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Bradicardia/metabolismo , Temperatura Baixa , Estudos Cross-Over , Eletrocardiografia/efeitos dos fármacos , Voluntários Saudáveis , Humanos , Mentha piperita , Óleos de Plantas/administração & dosagem , Psyllium/administração & dosagem , Termorreceptores/metabolismo , Adulto Jovem
6.
Can Vet J ; 59(3): 249-253, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29599554

RESUMO

A mare was euthanized because of gastric rupture secondary to complete duodenal obstruction by 2 bezoars located in the pylorus and proximal duodenum. Infrared spectroscopy showed that the bezoars were composed of psyllium. The mare had been receiving treatment with a pelleted psyllium product at 4 times the recommended dosage. Veterinarians should be aware that treatment of colic in horses with pelleted psyllium products could be associated with gastric impaction.


Rupture gastrique catastrophique secondaire à des pharmacobézoards de psyllium en boulettes chez un cheval. Une jument a été euthanasiée en raison d'une rupture gastrique secondaire à une obstruction duodénale complète par deux bézoards situés dans le pylore et le duodénum proximal. La spectroscopie infrarouge a montré que les bézoards se composaient de psyllium. La jument avait reçu un traitement composé d'un produit de psyllium en boulettes à quatre fois la dose recommandée. Les vétérinaires devraient être au courant que le traitement des coliques chez les chevaux avec des produits de psyllium en boulettes pourrait être associé à une impaction gastrique.(Traduit par Isabelle Vallières).


Assuntos
Bezoares/veterinária , Duodeno , Doenças dos Cavalos/diagnóstico , Ruptura Gástrica/veterinária , Animais , Bezoares/complicações , Catárticos/administração & dosagem , Catárticos/efeitos adversos , Diagnóstico Diferencial , Obstrução Duodenal/complicações , Obstrução Duodenal/etiologia , Obstrução Duodenal/veterinária , Evolução Fatal , Feminino , Doenças dos Cavalos/diagnóstico por imagem , Doenças dos Cavalos/etiologia , Cavalos , Psyllium/administração & dosagem , Psyllium/efeitos adversos , Ruptura Gástrica/etiologia
7.
Clin Gastroenterol Hepatol ; 15(5): 712-719.e4, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27080737

RESUMO

BACKGROUND & AIMS: We sought to determine the efficacy of psyllium fiber treatment on abdominal pain and stool patterns in children with irritable bowel syndrome (IBS). We evaluated effects on breath hydrogen and methane production, gut permeability, and microbiome composition. We also investigated whether psychological characteristics of children or parents affected the response to treatment. METHODS: We performed a randomized, double-blind trial of 103 children (mean age, 13 ± 3 y) with IBS seen at primary or tertiary care settings. After 2 weeks on their habitual diet, children began an 8-day diet excluding carbohydrates thought to cause symptoms of IBS. Children with ≥75% improvement in abdominal pain were excluded (n = 17). Children were assigned randomly to groups given psyllium (n = 37) or placebo (maltodextrin, n = 47) for 6 weeks. Two-week pain and stool diaries were compared at baseline and during the final 2 weeks of treatment. We assessed breath hydrogen and methane production, intestinal permeability, and the composition of the microbiome before and after administration of psyllium or placebo. Psychological characteristics of children were measured at baseline. RESULTS: Children in the psyllium group had a greater reduction in the mean number of pain episodes than children in the placebo group (mean reduction of 8.2 ± 1.2 after receiving psyllium vs mean reduction of 4.1 ± 1.3 after receiving placebo; P = .03); the level of pain intensity did not differ between the groups. Psychological characteristics were not associated with response. At the end of the study period, the percentage of stools that were normal (Bristol scale scores, 3-5), breath hydrogen or methane production, intestinal permeability, and microbiome composition were similar between groups. CONCLUSIONS: Psyllium fiber reduced the number of abdominal pain episodes in children with IBS, independent of psychological factors. Psyllium did not alter breath hydrogen or methane production, gut permeability, or microbiome composition. ClinicalTrials.gov no: NCT00526903.


Assuntos
Dor Abdominal/terapia , Fibras na Dieta/administração & dosagem , Síndrome do Intestino Irritável/terapia , Psyllium/administração & dosagem , Adolescente , Testes Respiratórios , Criança , Método Duplo-Cego , Feminino , Humanos , Masculino , Placebos/administração & dosagem , Resultado do Tratamento
8.
J Gastroenterol Hepatol ; 32 Suppl 1: 69-72, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28244666

RESUMO

Irritable bowel syndrome (IBS) is heterogeneous. Patients need proper assessment and explanation of IBS pathophysiology and appropriate therapies. A low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet effectively reduces symptoms in 75% of patients. Best treatment for those nonresponsive will depend on the pathophysiological basis for symptom genesis, with the following possible abnormalities: (i) Visceral hypersensitivity and/or enhanced gut-brain communication: a low FODMAP diet is mainly targeted for this patient group. A dietitian may also recommend antispasmodic agents, including peppermint oil. Another dietary treatment is a low food chemical diet, although this diet is often extremely limited, and therefore, not suited for some populations. Psychological therapies are also clinically beneficial. (ii) Altered motility: in patients with fast transit, a dietitian may recommend a reduction in all FODMAPs or targeted monosaccharides and disaccharides, which are more osmotic in nature. If not effective, patients may benefit from psyllium, which has an exceptional water-holding capacity aimed to promote more formed stools. Patients with slow or uncoordinated transit are often more difficult to treat. Dietary interventions have some success and usually comprise a combination of adequate fiber and fluid, osmotic laxatives, and stimulating agents such as caffeine, senna, and exercise. (iii) Altered microbiome: supplementary probiotics and prebiotics have weak evidence of efficacy with some notable exceptions. A dietitian may trial supplementary Bifidobacterium infantis or oligosaccharides, usually as an adjunct therapy. Guidance from a dietitian will encompass dietary methods to treat IBS but additionally identify where dietary treatment is not indicated to ensure that diet is correctly used and patients are not nutritionally or psychologically compromised.


Assuntos
Dieta com Restrição de Carboidratos , Síndrome do Intestino Irritável/dietoterapia , Bifidobacterium longum subspecies infantis , Dissacarídeos/administração & dosagem , Dissacarídeos/efeitos adversos , Fermentação , Motilidade Gastrointestinal , Humanos , Síndrome do Intestino Irritável/etiologia , Síndrome do Intestino Irritável/fisiopatologia , Laxantes/administração & dosagem , Mentha piperita , Monossacarídeos/administração & dosagem , Monossacarídeos/efeitos adversos , Oligossacarídeos/administração & dosagem , Oligossacarídeos/efeitos adversos , Parassimpatolíticos/administração & dosagem , Óleos de Plantas/administração & dosagem , Polímeros/administração & dosagem , Polímeros/efeitos adversos , Processos Psicoterapêuticos , Psyllium/administração & dosagem
9.
Nutr J ; 15(1): 86, 2016 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-27733151

RESUMO

BACKGROUND: Water-soluble dietary fibers intake may help control blood glucose and body weight. OBJECTIVE: The objective of the study was to determine whether soluble fiber supplementation from psyllium improves glycemic control indicators and body weight in type 2 diabetic patients. METHOD: Forty type 2 diabetes patients, non-smoker, aged >35 years were stratified to different strata according to sex, age, body mass index (BMI) and fasting blood sugar level (FBS) and randomly assigned into two groups; The intervention group which consists of 20 participants was on soluble fiber (10.5 g daily), and the control group which consist of 20 participants continued on their regular diet for eight weeks duration. RESULTS: After 8 weeks of intervention, soluble fiber supplementation showed significant reduction in the intervention group in BMI (p < 0.001) when compared with the control group. Moreover, water soluble fiber supplementation proven to improve FBS (163 to 119 mg/dl), HbA1c (8.5 to 7.5 %), insulin level (27.9 to 19.7 µIU/mL), C-peptide (5.8 to 3.8 ng/ml), HOMA.IR (11.3 to 5.8) and HOMA-ß % (103 to 141 %). CONCLUSION: The reduction in glycemic response was enhanced by combining soluble fiber to the normal diet. Consumption of foods containing moderate amounts of these fibers may improve glucose metabolism and lipid profile in type 2 diabetes patients. TRIAL REGISTRATION: Current Controlled Trials PHRC/HC/28/15 .


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Fibras na Dieta/administração & dosagem , Psyllium/administração & dosagem , Adulto , Índice de Massa Corporal , Peso Corporal , Peptídeo C/sangue , Dieta , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Circunferência da Cintura
10.
Appetite ; 105: 27-36, 2016 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-27166077

RESUMO

Controlling hunger between meals is a challenge for many individuals. This manuscript comprises 2 sequential clinical trials investigating the effects of psyllium (Metamucil) on satiety, both using a randomized, double-blind, placebo-controlled cross-over design. The first study determined the effects of 3.4 g, 6.8 g, and 10.2 g of psyllium taken before breakfast and lunch for 3 days. The second study determined the effects of 6.8 g (taken before breakfast and lunch on Days 1 and 2 and before breakfast on Day 3) on the satiety of participants receiving an energy restricted meal in the morning (breakfast) for 3 days. Efficacy endpoints were mean inter-meal hunger, desire to eat, and Satiety Labeled Intensity Magnitude Visual Analog Scale scores. In Study 1, all 3 psyllium doses resulted in directional or statistically significant mean reductions in hunger and desire to eat, and increased fullness between meals compared to placebo, with both higher doses better than placebo or 3.4 g. The 6.8 g dose provided more consistent (p ≤ 0.013) satiety benefits versus placebo. In Study 2, satiety was assessed similarly to Study 1. A significant (p ≤ 0.004) decrease in the 3-day mean hunger and desire to eat, as well as an increase in fullness for psyllium relative to placebo was observed. Most adverse events were mild gastrointestinal symptoms and were similar for psyllium compared to placebo. These results indicate that psyllium supplementation contributes to greater fullness and less hunger between meals.


Assuntos
Depressores do Apetite/administração & dosagem , Ingestão de Energia , Sobrepeso/prevenção & controle , Prebióticos , Psyllium/administração & dosagem , Resposta de Saciedade , Adulto , Depressores do Apetite/efeitos adversos , Depressores do Apetite/uso terapêutico , Índice de Massa Corporal , Desjejum , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Fome , Análise de Intenção de Tratamento , Almoço , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Sobrepeso/dietoterapia , Pacientes Desistentes do Tratamento , Prebióticos/efeitos adversos , Psyllium/efeitos adversos , Psyllium/uso terapêutico , Reprodutibilidade dos Testes , Adulto Jovem
11.
Dis Colon Rectum ; 58(10): 983-93, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26347971

RESUMO

BACKGROUND: Fecal incontinence is a devastating condition with few US Food and Drug Administration-approved pharmacologic treatment options. Loperamide and psyllium, both first-line treatments, have different mechanisms of action without any comparative data. OBJECTIVE: The purpose of this study was to examine the effectiveness and tolerability of loperamide compared with psyllium for reducing fecal incontinence. We hypothesized that psyllium fiber supplementation would be more effective than loperamide for reducing fecal incontinence episodes and have fewer adverse effects. DESIGN: We conducted a randomized, double-blind, placebo-controlled crossover trial comparing loperamide (followed by psyllium) with psyllium (followed by loperamide). SETTINGS: Our sites included outpatient clinics within a Veterans Affairs medical center and university affiliate. PATIENTS: Participants included community-dwelling adults (n = 80) with at least 1 fecal incontinent episode on a 7-day bowel diary. INTERVENTION: Participants received either daily loperamide (plus placebo psyllium powder) or psyllium powder (plus loperamide placebo) for 4 weeks. After a 2-week washout, participants crossed over to 4 weeks of alternate treatment. MAIN OUTCOME MEASURES: The primary outcome was the number of fecal incontinence episodes from 7-day bowel diaries. Secondary outcomes included symptom severity, quality of life, and tolerability. RESULTS: Mean age was 60.7 ± 10.1 years; 68% were men. After determining nonsignificant carryover effects, combined analyses showed no differences between the loperamide and psyllium groups for reducing fecal incontinent episodes, symptom severity, or quality of life. Within each group, both loperamide and psyllium reduced fecal incontinent episodes and improved symptom severity and quality of life. Constipation occurred in 29% of participants for loperamide vs 10% for psyllium. LIMITATIONS: Limitations include the washout period length and dropout rate after crossing over to the second intervention. CONCLUSIONS: Both loperamide and psyllium improve fecal incontinence. Loperamide was associated with more adverse effects, especially constipation.


Assuntos
Constipação Intestinal/etiologia , Incontinência Fecal , Loperamida , Psyllium , Qualidade de Vida , Idoso , Antidiarreicos/administração & dosagem , Antidiarreicos/efeitos adversos , Catárticos/administração & dosagem , Catárticos/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Incontinência Fecal/tratamento farmacológico , Incontinência Fecal/fisiopatologia , Incontinência Fecal/psicologia , Feminino , Humanos , Loperamida/administração & dosagem , Loperamida/efeitos adversos , Masculino , Pessoa de Meia-Idade , Psyllium/administração & dosagem , Psyllium/efeitos adversos , Avaliação de Sintomas , Resultado do Tratamento
12.
Br J Nutr ; 113(1): 134-41, 2015 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-25391814

RESUMO

The present study investigated the LDL-cholesterol (LDL-C)-lowering effects of psyllium in Brazilian dyslipidaemic children and adolescents. A total of fifty-one individuals (6-19 years) with mild-to-moderate hypercholesterolaemia were evaluated by conducting a randomised, double-blind, placebo-controlled, parallel clinical trial. Over an 8-week trial period, the participants were randomly allocated to one of two groups (control: n 25 and psyllium: n 26) using a computer-generated random number sequence. Fasting blood samples, dietary records and anthropometric data were collected. Both groups were treated with the National Cholesterol Education Program Step 2 diet for 6 weeks before randomisation. After this run-in period, a daily supplement of 7·0 g psyllium was given to the intervention group, while an equivalent amount of cellulose was given to the control group. Statistically significant changes between the control and intervention groups over time were observed for total cholesterol (7·7%; - 0·39 mmol/l; P= 0·003) and LDL-C (10·7%; - 0·36 mmol/l; P= 0·01). None of the participants reported any aversion to the smell, taste, appearance or texture of psyllium. No serious adverse effects were reported during the study. In addition to causing a significant reduction in LDL-C concentrations, psyllium therapy was found to be both safe and acceptable for the treatment of hypercholesterolaemic children and adolescents.


Assuntos
LDL-Colesterol/sangue , Hipercolesterolemia/tratamento farmacológico , Psyllium/administração & dosagem , Adolescente , Índice de Massa Corporal , Brasil , Criança , HDL-Colesterol/sangue , Suplementos Nutricionais , Método Duplo-Cego , Ingestão de Energia , Feminino , Humanos , Hipercolesterolemia/sangue , Masculino , Resultado do Tratamento , Triglicerídeos/sangue , Adulto Jovem
13.
J Pediatr Gastroenterol Nutr ; 58(5): 598-602, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24345842

RESUMO

OBJECTIVE: The aim of the present study was to evaluate the treatment adherence of children with chronic functional constipation. METHODS: The present study is a prospective and longitudinal study realized at a pediatric gastroenterology clinic of a Brazilian University Hospital, between August 2009 and October 2011. Rome III criteria and the Bristol Stool Scale were used to define constipation and to characterize feces, respectively. Drug treatment was prescribed for patients according to the protocols previously standardized in the clinic. Specific questionnaires, containing questions related to 1 dependent variable and independent variables were completed in the first and sixth months of the treatment. Independent variables related to the patients, their caregivers, the disease itself, and the therapeutic plan were analyzed and compared with the dependent variable (adherence to the treatment). Adherence was considered when the patient returned with >75% of the prescribed medicine containers empty. RESULTS: Fifty children participated in both the first and sixth months of treatment. The mean age of the sample was 77.6 ± 43.8 months and the mean age of the onset of symptoms was 18.8 ± 27.9 months. The adherence rate was 38% in the first month and 30% in the sixth month. Patients who were treated with polyethylene glycol had greater adherence than patients who were prescribed other laxatives, with statistical significance in the second moment of the study (P = 0.19 and P = 0.04, respectively). CONCLUSIONS: The study showed low adherence rates to drug treatment of constipation in children. It is necessary to seek new strategies to increase treatment adherence, while avoiding complications and reducing costs.


Assuntos
Constipação Intestinal/tratamento farmacológico , Cooperação do Paciente , Adolescente , Instituições de Assistência Ambulatorial , Brasil , Cuidadores , Criança , Pré-Escolar , Doença Crônica , Constipação Intestinal/psicologia , Pai , Fezes , Feminino , Humanos , Renda , Lactente , Laxantes , Estudos Longitudinais , Hidróxido de Magnésio/administração & dosagem , Masculino , Mães , Cooperação do Paciente/psicologia , Polietilenoglicóis/administração & dosagem , Estudos Prospectivos , Psyllium/administração & dosagem , Fatores Socioeconômicos , Inquéritos e Questionários
14.
Res Nurs Health ; 37(5): 367-78, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25155992

RESUMO

Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appears related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals incontinent of loose/liquid feces. The primary outcome was FI frequency; secondary outcomes included FI amount and consistency, supplement intolerance, and quality of life (QoL). Possible mechanisms underlying supplement effects were also examined. After a 14-day baseline, 189 subjects consumed a placebo or 16 g total fiber/day of one of the fiber supplements for 32 days. FI frequency significantly decreased after psyllium supplementation versus placebo, in both intent-to-treat and per-protocol mixed model analyses. CMC increased FI frequency. In intent-to-treat analysis, the number of FI episodes/week after supplementation was estimated to be 5.5 for Placebo, 2.5 for Psyllium, 4.3 for GA, and 6.2 for CMC. Only psyllium consumption resulted in a gel in feces. Supplement intolerance was low. QoL scores did not differ among groups. Patients with FI may experience a reduction in FI frequency after psyllium supplementation, and decreased FI frequency has been shown to be an important personal goal of treatment for patients with FI. Formation of a gel in feces appears to be a mechanism by which residual psyllium improved FI.


Assuntos
Fibras na Dieta/administração & dosagem , Incontinência Fecal/dietoterapia , Carboximetilcelulose Sódica/administração & dosagem , Feminino , Géis , Goma Arábica/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Psyllium/administração & dosagem , Qualidade de Vida , Método Simples-Cego , Resultado do Tratamento
15.
J Pediatr ; 161(4): 710-5.e1, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22677568

RESUMO

OBJECTIVES: To compare the effectiveness of a mixture of acacia fiber, psyllium fiber, and fructose (AFPFF) with polyethylene glycol 3350 combined with electrolytes (PEG+E) in the treatment of children with chronic functional constipation (CFC); and to evaluate the safety and effectiveness of AFPFF in the treatment of children with CFC. STUDY DESIGN: This was a randomized, open label, prospective, controlled, parallel-group study involving 100 children (M/F: 38/62; mean age ± SD: 6.5 ± 2.7 years) who were diagnosed with CFC according to the Rome III Criteria. Children were randomly divided into 2 groups: 50 children received AFPFF (16.8 g daily) and 50 children received PEG+E (0.5 g/kg daily) for 8 weeks. Primary outcome measures were frequency of bowel movements, stool consistency, fecal incontinence, and improvement of other associated gastrointestinal symptoms. Safety was assessed with evaluation of clinical adverse effects and growth measurements. RESULTS: Compliance rates were 72% for AFPFF and 96% for PEG+E. A significant improvement of constipation was seen in both groups. After 8 weeks, 77.8% of children treated with AFPFF and 83% of children treated with PEG+E had improved (P = .788). Neither PEG+E nor AFPFF caused any clinically significant side effects during the entire course of the study period. CONCLUSIONS: In this randomized study, we did not find any significant difference between the efficacy of AFPFF and PEG+E in the treatment of children with CFC. Both medications were proved to be safe for CFC treatment, but PEG+E was better accepted by children.


Assuntos
Constipação Intestinal/tratamento farmacológico , Fibras na Dieta/administração & dosagem , Eletrólitos/uso terapêutico , Frutose/administração & dosagem , Laxantes/uso terapêutico , Polietilenoglicóis/uso terapêutico , Psyllium/administração & dosagem , Criança , Pré-Escolar , Combinação de Medicamentos , Eletrólitos/química , Feminino , Humanos , Laxantes/administração & dosagem , Masculino , Polietilenoglicóis/química , Estudos Prospectivos
16.
J Am Coll Nutr ; 31(2): 94-9, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22855914

RESUMO

OBJECTIVE: To determine the effects of two water-soluble dietary fibers, ultrahigh-viscosity hydroxypropylmethylcellulose (UHV-HPMC, nonfermentable) and psyllium fiber (fermentable), on postprandial glucose and second meal effects. METHODS: In a single-blind crossover design, 12 healthy adult subjects were given standardized, premeasured breakfast and lunch meals with either 4 g of the fiber supplements or a placebo. Blood glucose was measured with a continuous blood glucose monitoring system (DexCom Seven Plus, San Diego, CA). RESULTS: Subjects consuming UHV-HPMC had significantly (p < 0.05) lower blood glucose area under the curve (AUC) 2 hours after breakfast than those receiving a placebo. Subjects consuming psyllium also tended to have lower glucose levels than the placebo group. Peak glucose concentration following breakfast was significantly (p < 0.01) less with UHV-HPMC when compared with the placebo. No significant differences in AUC or peak glucose concentration between treatments following the second meal (lunch) were detected, suggesting no residual effect from the fiber supplements. CONCLUSIONS: Supplementation with viscous water-soluble fibers may be an effective means of reducing the glycemic response of a meal in healthy adults.


Assuntos
Glicemia/efeitos dos fármacos , Desjejum , Suplementos Nutricionais , Metilcelulose/análogos & derivados , Período Pós-Prandial/efeitos dos fármacos , Psyllium/administração & dosagem , Adulto , Área Sob a Curva , Glicemia/análise , Estudos Cross-Over , Fibras na Dieta/administração & dosagem , Feminino , Fermentação , Humanos , Derivados da Hipromelose , Insulina/sangue , Almoço , Metilcelulose/administração & dosagem , Método Simples-Cego , Viscosidade , Adulto Jovem
17.
Int J Vitam Nutr Res ; 82(2): 113-20, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23065836

RESUMO

The aim of this study was to investigate whether L-Ascorbic acid would facilitate the anti-obesity effects of chitosan and psyllium husk in vivo. The study was carried out with male Hartley guinea pigs for 5 weeks. The results show that chitosan itself did not influence body weight gain and food efficiency ratio (FER). However, the addition of L-Ascorbic acid to chitosan decreased these parameters; the body weight gain and FER in the chitosan-2 group (high-fat diet group with 5 % chitosan containing 0.5 % L-Ascorbic acid) was significantly (p < 0.05) lower than that in F-controls (high-fat diet group), and was similar to that in controls (normal diet group). L-Ascorbic acid enhanced significantly (p < 0.05) the increases of total fecal weight and fecal fat excretion by chitosan. The addition of L-Ascorbic acid to psyllium husk did not differ from psyllium husk alone in terms of changes in weight gain, plasma lipid levels, and fat pad weight. We found that the addition of L-Ascorbic acid to chitosan influenced the reduction in body weight gain and FER, and the increase in total fecal weight and fecal fat excretion in guinea pigs fed a high-fat diet.


Assuntos
Fármacos Antiobesidade/administração & dosagem , Ácido Ascórbico/administração & dosagem , Quitosana/administração & dosagem , Obesidade/prevenção & controle , Psyllium/administração & dosagem , Animais , Dieta Hiperlipídica , Interações Medicamentosas , Gorduras/análise , Fezes/química , Cobaias , Masculino , Obesidade/etiologia , Aumento de Peso/efeitos dos fármacos
18.
ScientificWorldJournal ; 2012: 680108, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22649306

RESUMO

This paper describes preparation and characterization of beads of alginate and psyllium containing probiotic bacteria of Lactobacillus acidophilus DMSZ20079. Twelve different formulations containing alginate (ALG) and alginate-psyllium (ALG-PSL) were prepared using extrusion technique. The prepared beads were characterized in terms of size, morphology and surface properties, encapsulation efficiency, viabilities in acid (pH 1.8, 2 hours) and bile (0.5% w/v, 2 hours) conditions, and release in simulated colon pH conditions. The results showed that spherical beads with narrow size distribution ranging from 1.59 ± 0.04 to 1.67 ± 0.09 mm for ALG and from 1.61 ± 0.06 to 1.80 ± 0.07 mm for ALG-PSL with encapsulation efficiency higher than 98% were achieved. Furthermore, addition of PSL into ALG enhanced the integrity of prepared beads in comparison with ALG formulations. The results indicated that incorporation of PSL into alginate beads improved viability of the bacteria in acidic conditions as well as bile conditions. Also, stimulating effect of PSL on the probiotic bacteria was observed through 20-hour incubation in simulated colonic pH solution. According to our in vitro studies, PSL can be a suitable polymer candidate for partial substitution with ALG for probiotic coating.


Assuntos
Alginatos/administração & dosagem , Composição de Medicamentos/métodos , Lactobacillus acidophilus/crescimento & desenvolvimento , Microesferas , Probióticos/síntese química , Psyllium/administração & dosagem , Bile , Excipientes/administração & dosagem , Ácido Glucurônico/administração & dosagem , Ácidos Hexurônicos/administração & dosagem , Concentração de Íons de Hidrogênio , Tamanho da Partícula , Probióticos/administração & dosagem
19.
Consult Pharm ; 27(7): 513-6, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22910133

RESUMO

Increasing numbers of elderly individuals with diabetes look for natural means to manage their disease to reduce diabetes-related complications. The American Diabetes Association recommends a goal of 25 g to 35 g dietary fiber daily for a healthy diet. This review focuses on recent research that explores the utility of fiber and psyllium fiber in improving glucose control in patients with diabetes mellitus (DM). Fiber studies show decreased glucose concentrations and decreasing all-cause mortality. Small studies looking at psyllium fiber, in particular, have shown it to be associated with lower mean daily glucose concentrations, lower postmeal glucose concentrations, fewer hypoglycemic events, lower A1C levels, and lower insulin concentrations in people with DM. Results, as well as strengths and weaknesses of the studies, are presented. Considering the available research, we recommend elderly patients who are not able to meet their fiber goals by dietary intake consider psyllium supplementation.


Assuntos
Diabetes Mellitus/metabolismo , Fibras na Dieta/farmacologia , Psyllium/farmacologia , Idoso , Glicemia/efeitos dos fármacos , Fibras na Dieta/administração & dosagem , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/metabolismo , Política Nutricional , Psyllium/administração & dosagem , Sociedades Médicas , Estados Unidos
20.
Eksp Klin Gastroenterol ; (3): 62-7, 2012.
Artigo em Russo | MEDLINE | ID: mdl-22830226

RESUMO

The purpose of the research was the study of the prebiotic and hypolipidemic effects of 12-week treatment by psillium of patients with uncomplicated diverticular disease and hyperlipidemia. It has been established that the examined medicine has not any by-effects, normalizes intestinal motility and lowers a pain syndrome and flatulence. Prebiotic effect has proved by higher concentration of short-chain fatty acids in faeces and reduction of anaerobic index. Psillium certainly reduces levels of hyperlipidemia and could be recommended as hypolipidemic remedy for monotherapy as long as base datum of cholesterol is less than 6,4 mmol/l.


Assuntos
Catárticos/uso terapêutico , Diverticulose Cólica/tratamento farmacológico , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Psyllium/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Catárticos/administração & dosagem , Diverticulose Cólica/sangue , Diverticulose Cólica/complicações , Ácidos Graxos Voláteis/análise , Fezes/química , Feminino , Motilidade Gastrointestinal/efeitos dos fármacos , Humanos , Hiperlipidemias/sangue , Hiperlipidemias/complicações , Hipolipemiantes/administração & dosagem , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Psyllium/administração & dosagem , Resultado do Tratamento
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