@mollypelletier.rd: A lot of you asked if you should start psyllium husk after my last video. For plenty of you, my answer is no. Here is what the study tested. Rana and colleagues followed 505 people with confirmed LPR for 16 weeks. Everyone took a PPI. One group added a prokinetic, one added psyllium husk. The psyllium group reached 82% symptom resolution versus 65% on the PPI alone, with the best adherence of the three groups (Rana et al. 2025, Indian J Otolaryngol Head Neck Surg, PMID 40226240). That is a real result. Psyllium is also a gel-forming fiber that works by holding water, which is what keeps stool soft (McRorie and McKeown 2016, J Acad Nutr Diet). If you don't drink much water, it has nothing to work with. If you are already constipated, adding bulk to a slow gut often feels worse before it feels better. Constipation and reflux show up together constantly in my practice. What I use instead: • Soluble fiber from food: oats and oat bran, sweet potato, carrots, butternut squash, ripe banana. Oat beta-glucan is a viscous soluble fiber like psyllium, and food comes with its own water at a dose your gut can ramp into. • Sun fiber (partially hydrolyzed guar gum): water-soluble and non-gelling. In adults with chronic constipation, 4 weeks cut colon transit time from about 57 to 46 hours, and from about 86 to 64 hours in the slow-transit group (Polymeros et al. 2014, Dig Dis Sci). I still reach for psyllium, most often with bile reflux. Which fiber, what dose, and when to start depends on where you are in healing A lot of you asked if you should start psyllium husk after my last video. For plenty of you, my answer is no. Here is what the study tested. Rana and colleagues followed 505 people with confirmed LPR for 16 weeks. Everyone took a PPI. One group added a prokinetic, one added psyllium husk. The psyllium group reached 82% symptom resolution versus 65% on the PPI alone, with the best adherence of the three groups (Rana et al. 2025, Indian J Otolaryngol Head Neck Surg, PMID 40226240). That is a real result. Psyllium is also a gel-forming fiber that works by holding water, which is what keeps stool soft (McRorie and McKeown 2016, J Acad Nutr Diet). If you don't drink much water, it has nothing to work with. If you are already constipated, adding bulk to a slow gut often feels worse before it feels better. Constipation and reflux show up together constantly in my practice. What I use instead: • Soluble fiber from food: oats and oat bran, sweet potato, carrots, butternut squash, ripe banana. Oat beta-glucan is a viscous soluble fiber like psyllium, and food comes with its own water at a dose your gut can ramp into. • Sun fiber (partially hydrolyzed guar gum): water-soluble and non-gelling. In adults with chronic constipation, 4 weeks cut colon transit time from about 57 to 46 hours, and from about 86 to 64 hours in the slow-transit group (Polymeros et al. 2014, Dig Dis Sci). I still reach for psyllium, most often with bile reflux. Which fiber, what dose, and when to start depends on where you are in healing. That is what a Roadmap Session is for: a personalized nutrition and supplement plan built with a reflux Dietitian. More info on mollypelletier.com 🤍 #LPR #SilentReflux #AcidReflux #RefluxRelief #GutHealth

Molly | The Reflux Dietitian

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Friday 30 October 2026 12:12:51 GMT