Sugar feeds the bad bacteria that can lead to fermentation, gas, and a suppressed immune system. Aspartame is an artificial sweetener linked to so many health problems that it takes a book that’s nearly 1,000 pages long to document all of them (Roberts, J.J. MD. Aspartame Disease: An Ignored Epidemic, Sunshine Sentinel Press, Inc., West Palm Beach, FL). You may need a bulking agent. But you don’t need one with sugar or aspartame.

Psyllium seed comes from the Plantago ovata plant. Sometimes the seeds and husk are used as a bulking agent. Both are mucilaginous, which means that when you put them in water, they absorb a lot of water and form a gel, softening and increasing the size of solid wastes. Psyllium is particularly resistant to fermentation, so it’s not likely to cause gas.

The seed has several benefits over the husk. It contains more fiber and it breaks down more slowly, producing large amounts of butyric acid. Butyric acid prevents the development of cancer cells and appears to protect against colon cancer. In one study, a group of colon cancer patients who took 20 grams of psyllium seed a day for three months had a 42 percent increase in their butyric acid levels.

Psyllium’s many uses
The same butyric acid that blocks cancer cells may be responsible for psyllium’s beneficial activity in people with ulcerative colitis. When colitis patients were given 10 grams of psyllium seed twice a day, their remission was the same as when they took drugs containing mesalamine. Ask your doctor about using psyllium. You may be able to avoid more expensive medications.

Psyllium worked in 85 percent of people with chronic constipation with no pathological cause. It even reduced constipation by 37 percent in some patients who had rectal and intestinal disorders. But again, check with your doctor before taking anything for constipation to make sure you’re not masking symptoms from a more serious condition.

The mucilaginous effect of psyllium soothes your intestines. It significantly reduced bleeding from hemorrhoids in a study of 50 people. But to be effective with hemorrhoids, you need to take it for at least a month. Psyllium’s ability to absorb water also makes it valuable for people with diarrhea. In one study, psyllium decreased the occurrence of incontinent stools by a full 50 percent.

The longer you take this fiber, the better it seems to work. It lowers total cholesterol and the potentially harmful LDL cholesterol. A group of people who took a little over five grams of psyllium twice a day for two months had lowered total cholesterol and LDL levels. Another group of elderly patients had a 20 percent reduction in total cholesterol after taking psyllium for four months. Men and postmenopausal women, but not premenopausal women, had a significant drop in triglyceride levels after taking 15 grams of psyllium.

Avoid harmful ingredients
Many people with constipation reach for a laxative containing senna. It works, but while it stimulates muscle contractions and relieves constipation it can cause your intestines to lose some elasticity, creating a laxative dependency. A number of laxatives contain phenolphthalein, a chemical linked to an increased risk for cancer. The FDA has proposed a ban on phenolphthalein, but it’s still in some products. Read labels carefully and avoid phenolphthalein.

Modify your diet and lifestyle
Increase your intake of high-fiber foods in your diet. Beans and whole grains, or bran added to your morning cereal or juice, are particularly useful. If they give you gas, re-duce the amount and take digestive enzymes like pancreatin with meals temporarily. Increase your intake of water and get regular exercise. Before going to sleep at night, gently massage your belly in a clockwise motion for 10 minutes. This helps massage the colon, which encourages peristalsis and helps relieve constipation.

Add magnesium
I’ve said it before, but it bears repeating. Most people are magnesium deficient. We use more magnesium when we’re under stress, and chronic constipation, colitis, and high cholesterol are physically and emotionally stressful.

Magnesium is highest in whole grains, beans, and dark green leafy vegetables — foods you may not be eating. Too much magnesium causes loose stools. I tell my patients who are constipated to take 100-200 mg of magnesium once or twice a day to bowel tolerance. It’s often all they need to do.

Bottom line
Psyllium is a naturally occurring bulking agent with no side effects — unless you have an allergy to the plant. It is most effective when you take 10-30 gram doses a day for several months. Begin using the lowest amount in divided doses. Whether you have constipation, diarrhea, or intestinal inflammation, psyllium seed may be an effective and inexpensive remedy. Because it contains no artificial sweeteners, sugar, or potentially harmful chemicals, it’s safer than other over-the-counter bulking agents.

Monograph, Plantago ovata (Psyllium). Alternative Medicine Review, vol. 7, no. 7, 2002, 155-159.