Psyllium and similar plant fibres are the first-line treatment for the pharmaceutic therapy of constipation. A prerequisite for such a treatment is that a treatable organic cause is excluded and that all sensible non-pharmaceutical treatments have been exploited. Psyllium facilitates evacuation of the bowels by relieving excessive straining at stool. This is important, for instance, for hemorrhoids, anal fissure, or post anorectal surgery. For diverticular disease the formation of soft stool is also of particular importance. The benefits of a psyllium treatment for irritable bowel disease, however, is not convincingly documented.

Thanks to its capacity to bind water, psyllium may also be used for the symptomatic treatment of acute watery diarrhea and for the regulation of stool consistency with an artificial anus. It is inferior to a cholestyramine treatment for diarrhea caused by short gut syndrome.

According to numerous studies, psyllium dose not radically lower total and LDL cholesterol but it still does so significantly. It is therefore suitaable as a supplement for a low cholesterol diet.

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