In common with all bulk laxatives, ispaghula husk may increase or cause flatulence, although this usually disappears in the course of treatment. There is a risk of abdominal distension and intestinal or oesophageal obstruction and faecal impaction, particularly if ispaghula seed or husk is swallowed dry or without sufficient fluid. Allergic reactions, through oral administration, contact with the skin and, in the case of powder formulations, also by inhalation, can occur. These include skin symptoms such as exanthema and/or pruritus, rhinitis, conjunctivitis, bronchospasm and (rarely) anaphylactic reactions. Special attention should be given to individuals manipulating the powder formulations routinely (i.e. healthcare workers).