Does Regan help with constipation?

Does Regan Help with Constipation?

Psyllium (Regan) is an effective first-line treatment for chronic idiopathic constipation, with evidence showing it may increase spontaneous bowel movements per week and improve global symptom relief. 1

Evidence for Psyllium's Effectiveness

The 2023 American Gastroenterological Association-American College of Gastroenterology clinical practice guideline provides clear evidence supporting psyllium for constipation:

• Meta-analysis of 3 randomized controlled trials showed psyllium may increase spontaneous bowel movements (SBMs) per week by 2.32 compared to placebo 1
• Psyllium was associated with improved global symptom relief in 39.1% more individuals than placebo 1
• The guideline specifically recommends fiber supplementation for chronic idiopathic constipation, with psyllium being the most effective among evaluated fiber supplements 1

How Psyllium Works for Constipation

Psyllium is a soluble fiber that works through several mechanisms:

• Increases stool weight
• Reduces intestinal transit time
• May have prebiotic properties that promote gut health 1
• Absorbs water in the intestines, making stool softer and easier to pass

Dosing and Administration

For optimal results with psyllium (Regan):

• Start with 5g twice daily (based on clinical trials) 1
• Alternative dosing: 3.6g three times daily 1
• Always take with adequate water
• May take 1-3 days to see initial effects
• Full benefits may take up to 2 weeks

Implementation Considerations

When recommending psyllium:

1. Assess current dietary fiber intake first
2. Ensure adequate hydration (insufficient fluid intake can worsen constipation) 2
3. Start with lower doses and gradually increase to minimize side effects
4. Advise taking psyllium separate from medications (can interfere with absorption)
5. Monitor for improvement in bowel movement frequency and consistency

Potential Side Effects and Limitations

Common side effects include:

• Flatulence (most common) 1
• Abdominal bloating
• Potential for intestinal obstruction if taken without adequate fluid

When to Consider Alternative Treatments

If psyllium is ineffective after an adequate trial:

• For IBS with constipation: Consider linaclotide (strong recommendation, high-quality evidence) 1
• For chronic idiopathic constipation: Consider osmotic laxatives as next step
• For refractory cases: Specialized testing to identify potential dyssynergic defecation or slow-transit constipation 3

Clinical Pearl

The effectiveness of psyllium depends on adequate hydration. Dehydration can worsen constipation and reduce the efficacy of fiber supplements 2. Always advise patients to increase water intake when starting psyllium therapy.