Application Questions
How to take Mucofalk correctly in relation to food intake: before, after, during?
Mucofalk can be taken at any convenient time, except when it is taken to lower cholesterol, lose weight and reduce insulin resistance (for type 2 diabetes and impaired glucose tolerance) - in this case it is taken 15-30 minutes before meals.
It is important to space the intake of Mucofalk and other medications/dietary supplements by at least 40 minutes. - otherwise, psyllium may adsorb some of the drugs taken.
Will taking 150-200 ml of liquid complicate the condition of patients with kidney, heart and vascular diseases?
Even with minimal fluid requirements, it is necessary to consume at least 1.5 liters of fluid, as indicated in the instructions for use of the drug Mucofalk. Fluid deficiency (less than 1.5 liters per day) can cause constipation, thrombosis, kidney stones, etc.
When using Mucofalk, it is not necessary to exceed the physiological norm of fluid intake per day (2.0-2.5 liters of total fluid per day). When it comes to treating constipation, it is recommended that you take more fluids than usual as part of the general approach to treating constipation.
In any case, Mucofalk binds all the ingested liquid in the form of a gel - it does not enter the patient’s bloodstream.
Consequently, Mucofalk can be freely used in patients with cardiovascular diseases and other diseases when there are restrictions on fluid intake.
Is it possible to dissolve Mukofalk not only in water?
Mucofalk can be dissolved not only in water, but also in other liquids (kefir, milk, drinking yogurt, mineral water, juices, etc.).
Will there be a deficiency of fat-soluble vitamins and microelements when taking Mucofalk?
Psyllium has been used in world practice for a long time. Although it has pronounced properties of a natural enterosorbent, over the years of clinical experience there have been no cases of deficiency of vitamins and microelements during treatment with psyllium.
According to a meta-analysis of 8 studies on the use of psyllium for long periods (4-6 months or more), Mucofalk does not reliably affect the level of absorption of both vitamins and microelements (the concentrations of vitamins and microelements in the blood and urine were assessed).
One study examined the effect of psyllium on calcium absorption in 15 postmenopausal women in a randomized crossover study, the results of which showed that psyllium did not affect blood calcium levels.
Mukofalk
Mukofalk
(lat.
Mucofalk
®) is a laxative that increases the volume of feces. The active ingredient of mucofalk is psyllium (plantain seed shells). Mucolfalk is sold in packs containing sachets of 5 g of light brown granules with inclusions of brown particles of the peel and adjacent shell cells of dried seeds of the oval plantain Plantago ovata Forssk. A bag of Mucofalk (5 g) is intended for preparing 150 g of suspension. Each sachet contains 3.5 g of psyllium.
Mucofalk consists mainly of carbohydrates (902 mg/g), contains a small amount of vegetable proteins (35 mg/g) and other components (34 mg/g). Consists of three factions (Maev I.V. and others).
- Fraction A (30%) - not fermented by bacteria, increases the volume of intestinal contents, has a laxative effect due to mild stimulation of intestinal peristaltic activity.
- Fraction B (55%) is a gel-forming, partially fermentable fraction. It is represented by a highly branched arabinoxylan, consisting of a backbone formed by xylose, with arabinose- and xylose-containing side chains. Retains a significant amount of liquid, forming a gel, which has an enveloping effect, facilitating the passage of feces. The hydrocolloid matrix also acts as an enterosorbent, fixing molecules of sugars, bile acids, carcinogens and enzymes involved in lipid metabolism, and has hypoglycemic, hypolipidemic and antineoplastic effects.
- Fraction C (15%) - represented by a viscous mucous substance, easily fermented by intestinal bacteria, enhancing the growth of bifidobacteria and lactobacilli. In addition, the products of microbial decomposition of this fraction are short-chain fatty acids (SCFA), one of the key metabolic resources of colonocytes. SCFA, being the main source of energy for colonocytes, stimulate physiological proliferation of the epithelium, mucus formation, and enhance microcirculation in the mucous membrane. Antineoplastic and anti-inflammatory effects are associated with an increase in their concentration under the influence of psyllium.
Mechanism of action of Mucofalk
Fibers from the shells of psyllium seeds, present in Mucofalk, retain liquid in the intestine, the volume of its contents increases because of this, it becomes softer and the movement of chyme through the large intestine accelerates. Mucofalk helps normalize intestinal motility, reduce flatulence and abdominal pain.
Indications for use of Mucofalk
Mucofalk is indicated for:
- irritable bowel syndrome
- hemorrhoids
- anal fissures and fistulas
- hypotonic and atonic constipation, including in pregnant women
- functional diarrhea
- after operations on the anus.
How to take Mucofalk
Before use, the contents of one sachet or one teaspoon (5 g) of flour are poured into a glass, which is slowly filled with 150 g of cold water, stirred and immediately drunk.
The drunk dose of Mucofalk suspension is washed down with another glass of water. Adults and children over 12 years of age take from 2 to 6 doses of Mucofalk prepared in this way per day.
Use of Mucofalk during pregnancy, lactation and children
Pregnant and nursing mothers can use Mucofalk without restrictions. Children use Mucofalk starting from the age of 12 years, the administration procedure is the same as for adults.
Publications for healthcare professionals. concerning the use of Mucofalk
- Maev I.V., Dicheva D.T., Andreev D.N., Lebedeva E.G., Baeva T.A. Diverticular disease of the colon / Textbook for doctors. M. 2015. 22 p.
On the website in the literature catalog there is a section “Laxatives”, containing medical articles relating to the use of laxatives.
We also recommend that you read the articles
Constipation, ACG's 10 Tips for Constipation and Fecal Incontinence,
and the American Gastroenterological Association brochure
Constipation. The crux of the problem." Part I and Part II.
general information
Developer and manufacturer of Mucofalk: Doctor Falk Pharma GmbH (Germany) and Losan Pharma GmbH (Germany).
Other medicines with the same active ingredient (psyllium) registered in Russia: Naturallkas, Fiberlax. In the USA, a line of medicines, medicinal cookies, and prebiotics are produced based on psyllium under the trade name Metamucil. Metamucil is not registered in Russia.
According to ATC, Mucofalk belongs to the group “A06AC Laxatives that increase the volume of intestinal contents” and has the code “A06AC01 Isfagul (plantain oval or flea seed)”.
Mucofalk has contraindications, side effects and application features; consultation with a specialist is necessary.
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Weight loss
Mucofalk® in weight loss programs
The gold standard treatment for obesity, metabolic syndrome, and nonalcoholic fatty liver disease is diet and physical activity. To date, all medications and psychotherapy used for obesity are considered only as aids to help you follow the chosen diet.
The table shows the main diets and the ratios of proteins, carbohydrates, fats in them, divided into different fractions. It can be seen that the diets are very similar in the composition of the main nutritional components; the only difference is in the recommended amounts of dietary cholesterol, mono- and polyunsaturated fatty acids. However, all diets recommend taking a large amount of dietary fiber (20–30 g per day), since, according to numerous studies, a deficiency in dietary fiber significantly increases the risk of developing obesity
Table. Basic diets and their ratios of proteins, carbohydrates and fats
A natural question arises: which diet to choose? Is there a most effective diet? The answer to this question requires consideration of modern evidence-based dietary approaches to the treatment of obesity, taking into account the latest clinical research in this area.
A study by Sacks et al compared the effectiveness of four diets with different ratios of key macronutrients. The study included 811 obese patients, each of whom followed one of four diets. The percentages of energy obtained respectively from fat, protein and carbohydrates for the four diets were as follows: 20, 15 and 65%; 20, 25 and 55%; 40, 15 and 45%; 40, 25 and 35%. That is, the share of main macronutrients in the diet varied significantly: for fats - from 20 to 40%, for carbohydrates - from 35 to 65%. At the same time, the diet was calculated in such a way that study participants consumed 750 kcal per day less than their individual level of energy expenditure. The total duration of the study was two years. The results of the study (Fig. 1) showed that after 6 months, the reduction in body weight on all diets averaged 6 kg. After a year, patients began to show weight gain, which is a characteristic feature of long-term adherence to dietary recommendations. After two years, the average weight loss was 4 kg, although the weight loss in 14–15% of patients was 10% of the initial weight. The principal result of the study was the absence of a statistically significant difference in effectiveness in favor of one diet or another.
Thus, it has been proven that the effect of weight loss depends only on the overall reduction in caloric intake of the diet; the composition of the diet does not affect the degree of body weight loss.
Fig. 1 The composition of the diet does not affect the degree of body weight loss; the effect depends only on the overall reduction in calorie content of the diet
Since all diets are equally effective, regardless of their composition, and the main thing is to reduce the total calorie content, the question of the effectiveness of the diet, in fact, comes down to the question of its tolerability, given that it is necessary to adhere to dietary recommendations for a long time, sometimes for several years. Therefore, the main problem that reduces the effectiveness of diets is usually low adherence to them. This is precisely the key question that needs to be answered in the form of practical recommendations, since the most effective diet will be the one that the patient can stick to for a long time.
On the one hand, with the existing variety of diets, the patient can choose the diet that is most suitable for him, taking into account personal preferences and eating habits and, accordingly, characterized by better individual tolerance. On the other hand, the question arises whether there are any universal approaches to improving diet tolerance. It should be noted that recently there has been a shift in focus from the role of the ratio of food nutrients and functional ingredients towards a holistic diet and eating behavior.
From the physiology of the digestive system it is well known that the feeling of satiety largely depends on the degree of distension and the rate of emptying of the stomach. It has been established that a person is more focused on consuming a constant weight and volume of food than he is inclined to adhere to a certain daily calorie intake. Thus, building a diet on portions of food that are sufficient in volume and, accordingly, satisfying to the patient, but with a lower calorie content, can increase the long-term tolerability of such a diet. It is known that 1 g of fat contains 9 kcal, 1 g of proteins and carbohydrates - 4 kcal, 1 g of dietary fiber - 1.5-2.5 kcal, water contains no calories. The mention of water is not accidental, since food with a high water content has a significantly reduced energy capacity, and a number of recent clinical studies have assessed the effectiveness and tolerability of diets containing foods with a high water content (primarily vegetables and fruits) in obesity.
Figure 2 shows the results of a study by Martin et al that compared the effectiveness of two dietary regimens in obese women. One group was advised to limit their intake of fatty foods (RF), while the second was advised to reduce their intake of fatty foods while increasing their intake of foods high in water content through vegetables, fruits and vegetables (RF+FV). In the second group, patients consumed food with lower energy density. As a result, although both groups showed a significant decrease in body weight (p < 0.0001), the second group (RF + FV) demonstrated a more pronounced and statistically significant decrease in body weight than the first group (6.4 ± 0.9 kg versus 7 .9±0.9 kg, p=0.002). Patients in the second group (RF+FV) also reported a less pronounced feeling of hunger than in the first group (p=0.003).
Fig. 2 Changes in body weight over one year in obese women
A large clinical trial called PREMIER, which included 658 participants, assessed the effect of dietary energy capacity on body weight. The study was carried out over 6 months. Patients with a predisposition to hypertension and patients with arterial hypertension (HTN) and overweight were randomized into one of three groups: the first group received standard recommendations for patients with hypertension (weight loss, decreased sodium intake, increased physical activity) and participated in 18 consultation sessions, the second group - standard recommendations for patients with hypertension and a special diet for hypertension (DASH - Dietary Approaches to Stop Hypertension), also participants in this group participated in 18 consultation sessions; the third group received only one consultation on the application of standard recommendations for patients with hypertension and a special diet for hypertension (DASH). Each patient kept a food diary.
Each group showed significant reductions in energy intake, food energy content, and weight loss. The most pronounced reduction in energy consumption and body weight was noted in the first and second groups. The second group (standard recommendations and DASH) showed the most significant decrease in the energy content of food with a simultaneous increase in the volume of food consumed.
Additional analysis by combining all groups to examine the relationship between food energy content and weight loss showed that patients with the greatest decrease in food energy content (top tertile - Z) achieved the greatest weight loss (5.9 kg) than the average patients (4.0 kg) and lower (2.4 kg) tertiles (Fig. 3). Patients in the top (Z) and middle (Y) tertiles increased food intake by 300 and 80 g/day, respectively, but decreased energy intake by 500 and 250 kcal/day, respectively. In contrast, in the lowest tertile (X) there was a decrease in food intake of 100 g per day, with little change in daily energy intake.
Fig. 3 The influence of the energy capacity of food on the volume of food consumed (A), the amount of energy consumed (B) and body weight (C)
Thus, participants who consumed the lowest energy-dense foods showed the greatest reductions in energy intake and body weight. At the same time, this group experienced an increase in the amount of food consumed, which increased adherence to this type of diet, since better control of hunger was achieved. In addition, the diet with the lowest energy content was of better quality: the intake of dietary fiber, minerals and vitamins increased (primarily due to the consumption of vegetables and fruits).
The main strategies for reducing the energy content of food in order to reduce body weight can be summarized as follows:
- Increasing the amount of food with a high water content in the diet has the greatest effect, while taking water separately from food has no effect; it is water in the food that is important.
- The second most important thing is to reduce the amount of fat consumed.
- Reducing the amount of simple sugars and replacing them with complex carbohydrates is the third line in diet correction.
The characteristics of fats that make it necessary to limit their consumption in the treatment of obesity are well known and are listed below: highest energy density - 9 kcal/g; the storage of fats requires less energy than the storage of carbohydrates; foods rich in fat cause less active post-alimentary thermogenesis; High-fat foods taste better than low-fat foods (taste is largely due to fat-soluble flavor molecules); Unlike foods rich in fiber, foods rich in fat do not require long chewing, which also leads to overeating.
As for foods with a high water content, it is primarily expected to increase the consumption of vegetables and fruits, and dairy products. However, along with food products, food modifiers can also be widely used, the use of which can significantly improve the tolerability of the diet and/or optimize the order of its administration. The food modifier helps achieve a feeling of fullness with less calorie consumption, that is, similar in effect to food with a high water content. For a number of reasons, the patient is not always able to change his diet to the required extent only through vegetables and fruits. Therefore, along with dietary changes, food modifiers are used as additional means. When choosing a food modifier, you must be guided by the rule: lower calorie content with a larger volume. However, of course, the organoleptic properties of the food modifier and ease of administration are also important.
In this case, mucofalk is the optimal dietary fiber for use as a food modifier in weight loss programs, primarily due to its high water-binding capacity. One gram of psyllium binds 30 ml of water, one dose of Mucofalk (1 sachet) binds 150 ml of water.
The regimen for using the drug Mucofalk® as part of a diet for weight loss consists of taking 2-3 sachets per day (6-10 g of psyllium per day). Psyllium can be taken long-term. It is recommended to take the drug 15–30 minutes before a meal or during a meal, preferably in the form of a gel (infuse the solution until a jelly forms), since the effectiveness is determined by the complex of water associated with dietary fiber and the dietary fiber itself.
