Effect of Plantago (psyllium) on Prevention of Constipation in Patients with Acute Myocardial Infarction: A Randomized Triple-Blind Clinical Trial

Document Type : Original Article(s)

Authors

1 MSc in Nursing, Amir-Al Momenin Hospital, Arak, Iran

2 Professor, Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran

3 Associate Professor, Department of Nursing ,School of Nursing, Arak University of Medical Sciences, Arak, Iran

4 Assistant Professor, Department of Internal Medicine (Cardiology), School of Medicine, Arak University of Medical Sciences, Arak, Iran

Abstract

Background: Constipation is one of the most common gastrointestinal complaints among hospitalized patients due to acute myocardial infarction. So, this study was conducted to determine the effect of Plantago on constipation prevention in patients with acute myocardial infarction.
Methods: This research was a triple-blind randomized clinical trial that was conducted on patients with acute myocardial infarction admitted to cardiac intensive care units in Amirkabir and Amiral Mominin hospitals in Arak City in 2017, in two intervention and control groups. In this study, the intervention group received a sachet of saffron shell powder and the control group received a packaged cellulose sachet in an empty stomach for three days. Demographic information and Criteria for Assessing Constipation Symptoms (CACS) were used to collect data. The data were analyzed using the chi-square test.
Findings: Of 110 patients, 62 (56.36%) cases were female, and 48 (43.63%) were male. The mean and standard deviation of the patient's age in the intervention group was 64.58 ± 3.7 and 64.2 ± 2.7 years in the control group. At the end of the study, of 55 patients in the intervention group, 14(25.45%) patients had constipation, and 41 (74.55%) patients did not have constipation. But, all the patients in the control group suffered from constipation.
Conclusion: The results showed that consumption of Plantago among patients hospitalized in cardiac care units (CCU) prevented the occurrence of constipation.

Keywords

Main Subjects


  1. Ghanbari Afra L, Zaheri A. Relationship of anxiety, stress, and depression with spiritual health in patients with acute coronary artery disease [in Persian]. J Educ Community Health 2017; 4(2): 28-34.
  2. Cardiovascular diseases (CVDs). [Online]. [cited 2021 June 11]; Available from: URL: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
  3. Boomi Ghuchane Atigh M, Malekaneh M, Mashreghi Moghaddam H, Anani Sarab G. Evaluation of oxidative stress and homocysteine level in patients with acute myocardial infarction: a case-control study [in Persian]. J Birjand Univ Med Sci 2016; 23(2): 141-8.
  4. Mozaffar Pour A, Mojahedi M. Explanation the definition of constipation and compare its different causes in Iranian traditional medicine and modern medicine [in Persian]. Islam and Iran Trad Med 2012; 3(2): 162-73.
  5. Elsagh M, Hadizade F, Mazaheri M, Yavari M, baabian M, Sharifi A, et al. Constipation in traditional Iranian medicine [in Persian]. Islam and Iran Trad Med 2012; 2(4): 361-71.
  6. Homani F. Digestive and gastrointestinal function [in Persian]. 13th Tehran, Iran: Haidari publication; 2020. p. 65-75.
  7. Kasper D, Fauci A, Hauser S, Longo D, Jameson JL. Harrison's Gastroenterology and Hepatology, 3rd Edition (Harrison's Specialty). 3rd Philadelphia, PA: McGraw Hill / Medical; 2016.
  8. Badiee S, Nazari SM, Anushiravani M, Hosseini SMR, Noras MR. A brief review on constipation in persian and chinese traditional medicine [in Persian]. J Mazandaran Univ Med Sci 2015; 25(123): 222-9.
  9. Ishiyama Y, Hoshide S, Mizuno H, Kario K. Constipation-induced presser effects as triggers for cardiovascular events. J Clin Hypert 2019; 21(3): 421-5.
  10. Zukhri S, Setianingsih, Hastuti RY, Setyaningsih I. Risk factors analysis of constipation in patients with acute coronary syndrome. J Physics Conf Ser 2018; 9(2): 1-6.
  11. Mozafarpour SA, Naseri M, Ismaili M, Bijani A, Kamali Nejad M, Yousefi M, Mojahedi M, Khodadost M. Introduction of effective drugs in the treatment of constipation in traditional Iranian medicine [in Persian]. Med Hist Quar 2012; 3(9): 34-9.
  12. Jafarpour M, Ghannadi AR, Ghaemi H, Mosaffa Jahromi M. The cause of particular concern about not taking the complete seed powder of esfarzeh in Iranian traditional medicine [in Persian]. J Islam and Iran Trad Med 2011; 2(1): 53-60.
  13. Naghdi Badi H, Dastpak A, Ziai S. A review of psyllium plant [in Persian]. J Med Plants 2004; 3(9): 1-14.
  14. Ghasemi Dehkordi N. Farmacopia plant of Iran [in
    Persian]. 3rd Tehran, Iran: Ministry of Health and Medical Education for food and medicine; 2011.
    p. 256-65.
  15. Pishvaei M, Pishvaei Z, Kian Mehr M, Pishvaei. On the benefits of psyllium in medicine [in Persian]. Proceeding of the National Conference on Natural Products and Medicinal Plants. 2013; p. 174-90.
  16. Singh B. Psyllium as therapeutic and drug delivery agent. Int J Pharm 2007; 334(1-2): 1-14.
  17. Agah Sh, Taleb AM, Moeini R, Gorji N, Nikbakht H. Cumin extract for symptom control in patients with irritable bowel syndrome. Middle East J Dig Dis 2013; 5(4): 217-22.
  18. Sami P. Herbal medicines in Iran with nursing and care measures [in Persian]. Tehran, Iran: Boshra; 2019. p. 70-9.
  19. Emami A, Fasayhi S, Mehregan A, Mohammadpour A, Khalili H, Taleb AM. Reference book of medicinal plants [in Perdian]. Volume II. Tehran, Iran: Andisheavar; 2020. p. 1053-63.
  20. Portalatin M, Winstead N. Medical management of constipation. Clin Colon Rectal Surg 2012; 25(1): 12-9.
  21. McMillan SC, Williams FA. Validity and reliability of the constipation assessment scale. Cancer Nurs 1989; 12(3): 183-8.
  22. McMillan SC. Presence and severity of constipation in hospice patients with advanced cancer. Am J Hosp Palliat Care 2002; 19(6): 426-30.
  23. Pouladi S, Bagherpour Borazjani A, Motamed N, Amini A, Rahbar A, Vahedparast H, et al. A Survey on the effect of psyllium on serum levels of Triglycerid and lipoproteins [in Persian]. Iran South Med J 2009; 11(2): 139-46.
  24. Cheskin L, Mitola A, Ridoré M, Kolge S, Hwang K, Clark B. A naturalistic, controlled, crossover trial of plum juice versus psyllium versus control for improving bowel function. Internet J Nut Wellness 2009; 7(2): 1-10.
  25. Ghahramani L, Hosseini SV, Rahimikazerooni S, Bananzadeh AM, Namavar Jahromi B, Samsam A,
    et al. The effect of oral Psyllium herbal laxative powder in prevention of Hemorrhoids and Anal Fissure during Pregnancy, a Randomized Double
    Blind Clinical Trial. An Colorectal Res 2013; 3(1): 2-7.
  26. McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther 1998; 12(5): 491-7.
  27. Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ. Systematic review: The role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 2004; 19(3): 245-51.
  28. Bahrami HR, Hamedi Sh, Salari R, Noras MR. Herbal medicines for the management of irritable bowel syndrome: a systematic review. Electron Physician 2016; 8(8): 2719-25.
  29. Agah S, Fatali S, Ashayeri N. Treatment of diarrhea predominant irritable bowel syndrome (ibs-d) using plantagel: A random double-blind clinical trial [in Persian]. Razi J Med Sci 2010; 16(12): 17-23.
  30. Rahimi R, Abdollahi M. Herbal medicines for the management of irritable bowel syndrome: A comprehensive review. World J Gastroenterol 2012; 18(7): 589-600.
  31. Salehi Sourmaghi MS. Introduction to herbal medicine and herbal therapy [in Persian]. Tehran, Iran: World of Nutrition; 2021. p. 95-108.
  32. Madgulkar AR, Rao MR, Warrier D. Characterization of Psyllium (Plantago ovata) Polysaccharide and Its Uses. In: Merillon JM, Ramavat KG, editors. Polysaccharides, bioactivity and biotechnology. Berlin, Heidelberg: Springer; 2015. p. 871-90.
  33. Hatefi A, Sadeghi T, Emtiazy M. Comparing the Effect of Golghand and Psyllium on constipation among the elderly: A randomized clinical trial. J Med Plants 2018; 17(65): 25-34.
  34. Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomized clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther 2011; 33(7): 822-8.
  35. Hosseini M, Salari M, Salari Psyllium seed may be effective in the treatment of gastroesophageal reflux disease (GERD) in patients with functional constipation. J Med Hypoth Id 2015; 9(2): S4-7.