Effect of psyllium, calcium polycarbophil, and wheat bran on secretory diarrhea induced by phenolphthalein.
BACKGROUND
Fiber and water-holding agents are used for the treatment of constipation. In what may appear to be a paradox, they are sometimes also used for the treatment of diarrhea; it has been proposed that they sequester water from liquid stools and/or increase the ratio of fecal solids to fecal water and thereby improve stool consistency. The purpose of the present study was to test the validity of this hypothesis in normal subjects in whom secretory diarrhea was induced by phenolphthalein.


METHODS
In random sequence, 9 subjects with phenolphthalein-induced diarrhea were treated with placebo, psyllium, calcium polycarbophil, or wheat bran.


RESULTS
Calcium polycarbophil and wheat bran had no effect on fecal consistency or on fecal viscosity. By contrast, psyllium made stools firmer and increased fecal viscosity. In a dose-response study in 6 subjects, doses of 9, 18, and 30 g of psyllium per day caused a near linear increase in fecal viscosity.


CONCLUSIONS
Psyllium, but not calcium polycarbophil or wheat bran, improves fecal consistency and viscosity in subjects with experimentally-induced secretory diarrhea.
Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas.
A J
AJ
Eherer
C A
CA
Santa Ana
J
J
Porter
J S
JS
Fordtran
D000180:Acrylic Resins / Q000494:pharmacology*; D000328:Adult; D000930:Antidiarrheals / Q000494:pharmacology*; D003967:Diarrhea / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology*; D004043:Dietary Fiber; D005260:Female; D006801:Humans; D008297:Male; D020113:Phenolphthalein; D010635:Phenolphthaleins; D011620:Psyllium / Q000494:pharmacology*; D014908:Triticum
D000180:Acrylic Resins; D000930:Antidiarrheals; D004043:Dietary Fiber; D010635:Phenolphthaleins; D020113:Phenolphthalein; D011620:Psyllium; C030312:calcium polycarbophil