Cholesterol Reduction Using Psyllium Husks--Do Gastrointestinal Adverse Effects Limit Compliance? Results of a Specific Observational Study (Clinical Report‪)‬

Introduction Despite the known cholesterol reducing effect of psyllium seed husks (PSH) that has been shown in a number of studies (Garvin et al., 1965; Levin et al., 1990; Chan and Schroeder, 1995; Anderson et al., 2000), their use for therapy of mild or moderate hypercholesterolemia in Germany is quite rare. One reason may be that until now there were only a few registered herbal drug products with this indication since PSH is mainly used as a laxative. Although patients often express a preference for herbal products over synthetically manufactured drug products, patients may be somewhat reticent to use the PSH products due to unwanted intestinal effects. It is known that ingesting PSH can cause meteorism from bacterial fermentation in the colon which is associated with gastrointestinal complaints of bloating, flatulence and even painful cramps. Although these unwanted effects are usually considered minor compared with rare but severe adverse reactions associated with commonly prescribed statins used to lower cholesterol, it is possible that the side effects associated with ingesting PSH limit patient compliance. Therefore we designed a study to characterize the incidence and tolerability of PSH treatment in an outpatient population with mild to moderate hypercholesterolemia and a medical indication for laxative treatment.