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Metamucil is one of the most popular fiber laxatives in North America. It has been around since 1934. Since 1984, it has been manufactured by Proctor & Gamble, who have made it available as a drink powder in orange, berry, and lemonade flavors, with and without sugar, in capsules, and as several flavors of "cookies" (biscuits).

The most important ingredient in Metamucil is an herb, ground psyllium seed husks. The husks are insoluble, and they are hygroscopic, that is, they asborb large amounts of water. If you take about 3.5 grams (a heaping teaspoon) of the ground psyllium husks every day, and drink several glasses of water, they will swell in your colon that you have a constant amount of stool, and you can have regular bowel movements.

If you don't take Metamucil (or other ground psyllium products) with enough water, they can cause serious problems. One of these problems is esophageal food bolus obstruction. This is the problem that is most likely to cause severe chest pain after using psyllium. A bolus of "wad" of damp psyllium powder can lodge at the base of the throat. It can cause neck or chest pain, drooling, and severe difficulty swallowing.

Most of the time, esophageal obstruction with Metamucil is just extremely uncomfortable. It has the potential, however, to cause aspiration of bits of Metamucil into the lungs (aspiration) and even perforation, tearing. of the esophagus itself. These are potentially fatal complications.

Metamucil not taken according to product directions can also cause choking. Tiny particles of Metamucil lodge on the sides of the throat. Drinking additional fluid after taking Metamucil, instead of with the Metamucil can cause these particles to swell up in place, cutting off the flow of air. In healthy people, this is likely just to be uncomfortable. In the elderly or in people who have weak throat muscles, it can cause serious breathing problems.

These problems can be avoided if one simply takes Metamucil with the prescribed amount of water. 

If you can't or won't take a full glass (500 ml) of water with the product, then don't use the problem. A better choice would be Milk of Magnesia. Milk of Magnesia also absorbs water and makes it easier for the muscles lining the colon and rectum to expel stool. It does not, however, provide a constant amount of stool inside the colon for regularity.

Some people are allergic to psyllium husks. They will get wheezing, sneezing, teary eyes, and possibly hives within a few minutes of using the product. There may be swelling of the throat in the most severe cases, but there won't necessarily be obstruction (something stuck in) the throat. Allergies of this kind can also cause diarrhea, vomiting, nausea, dizziness, and severe fatigue. There are many alternatives to psyllium poweder for treating diarrhea, so there is no reason to start taking Diphenhydramine (Benadryl) before using the product to avoid allergic reactions. Simply use something else.

Be careful, however, about using stimulant laxatives in place of psyllium powder. Stimulant laxatives are made from certain herbs, such as cascara (nicknamed the "brown bomb"), Senna, aloe, or rhubarb root, or with certain chemicals, such as biscodyl (Dulcolax) or phenolphthalein (Correctol, Ex-Lax). The herbal laxatives actually won't work if you don't already have probiotic bacteria in your bowel. Bacteria have to transform chemicals in the herbs into forms that make the muscles lining your colon and rectum move. The chemical laxatives don't require the help of probiotic bacteria to be effective, but they can be harsh. Ready or not, you will have a bowel movement, even if your stool is not soft and your muscles are strained.

The effects of both herbal and chemical stimulant laxatives wear off over time. 

If you use them for more than two weeks at a time, you may need more and more to get the same effect. You can become dependent on stimulant laxatives, suffering severe constipation if you don't take more and more. It is much better to eat vegetables and fruit every day, to maintain probiotic bacteria (which form up to 1/3 of the volume of stool), and to drink plenty of water, taking laxatives of any kind only on rare occasions, to maintain your regularity.

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