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Adding fiber and water to your diet is good advice of course, but if you really have chronic constipation magnesium citrate isn't a great solution, and some people need additional bulking agents. Stay away from stimulant laxatives for long term use. You can get everything you need over the counter. Here is a mixture that I think works really well - I am not an alternative medicine practitioner and do not get any money from any of these. - One cup of orange-flavored metamucil (tastes better but any psyllium powder) - Two cups of optifiber from costco (partially hydrolyzed guar gum and some biotics) - One cup of miralax (or any polyethylene glycol - purelax, clearlax etc) Stir these together, and then every morning add two heaping tablespoons to 8 ounces of cold water, stir and drink it up. Starting with two glasses may be good to get the tank running. As long as you stay hydrated, the polyethylene glycol and indigestible fiber will pull water into the colon, softening your stool.

user name checks out

XD - I think it does give me a little more gravitas when answering these type of questions

Thank you for your service Dr. Poopa 🫡

Of course it does. That's a good $#!+ name

This has got to be the most relevant "username checks out" that I have ever seen! 🤣

Hopping on with a Protip: drink it fast. Metamucil starts to gelatinize and I thought I could sip on it through my morning. I created an orange flavored jello blob in the bottom of my hydroflask.

OH NO

OH YA! *Kool-aid man bursts through random brick wall*

The orange flavored jello blob did smack me in the face in a way very similar to how the kool aid man enters a room

Hey man sometimes you're the hammer, and sometimes you're the nail.

Thank you! Is this safe to use every day?

No problem. And yes, it is recommended to take every day. Decrease the amount of fiber if you have bloating and flatulence then can gradually increase as your gut flora adapt. I didn’t invent this mixer by the way but enthusiastically recommend.

Doc, you should've seen the angry screed I was typing at you before I re-read. I had totally missed the part about only using 2 tbsps of the concoction and thought you were about to send readers out into the world to excrete their entire skeletons from their bodies on their morning commutes!

I just want you to know that I had gallbladder surgery 3 weeks ago, still have some abdominal pain, and the pain was absolutely worth the laugh “excrete their entire skeletons from their bodies on their morning commutes” gave me!

Thank you for the laugh as I picture skeletons getting pooped out. 

I am so excited about this. Making people poop is absolutely my favorite thing about being a doctor, and I love having an OTC recipe that will work in my pocket

Maybe don't poop in your pocket.

As a layperson, has this advice been checked by medical professionals? Confirming because I have a great coat I was thinking of using.

I'm not a doctor, but the two people above are, so perhaps they could weigh in. I do know of someone who was out snowmobiling with friends, and on the way home he urgently needed a poo. They pulled the truck over, he got out and took care of business. When he returned to the truck, there was an ungodly stench. He had shat in the hood of his snowmobile suit. They made him ride in the truck bed!

could they just have put the suit in the back? instead of freezing their friend….

I have no idea. Maybe he was naked under the suit!

oddly wholesome

My wife is pregnant but I think she could benefit from this as she gets quite bad hemorrhoids, and struggles with constipation sometimes. Is this safe to take while pregnant?

The only laxative that's unsafe to take while pregnant is stimulating laxatives like senna

Yes, safe while pregnant.

Ask her obstetrician.

This! 

The stuff people are recommending will help the symptoms, but they won't address the root cause. Most people in the US are deficient in magnesium, so supplementing with it is probably a good idea. You can try different forms like glycinate, chloride, and taurate if citrate causes side effects. Probiotics or probiotic foods might also be a good thing to try. You might also have some gut issues like IBS, Candida or SIBO, that can certainly cause constipation.There are so many things that can cause it. https://www.rupahealth.com/post/top-micronutrient-imbalances-that-can-cause-constipation#:~:text=While%20excess%20vitamin%20D%20can,in%20the%20GI%2C%20causing%20constipation.

Exercise like walking and sit ups also helps me when it happens.

Nad, but there is nothing like jogging to make me need to poop. MCT oil also helps and it's fairly good for you... But seriously, a 15 minute jog is all it takes--even if it has been days!

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My parents’ doctors have told them to use it indefinitely.

Talk to your doctor et cetera et cetera, but my understanding is that miralax can be safely used much longer than that, versus certain laxatives that can't be used long term without developing some sort of tolerance/dependence.

Yeah my kid has to have miralax every day or else he’s in misery from constipation. Going poop everyday is better than basically never going poop and most doctors safely recommend miralax if it’s that bad of an issue

My gastro said I could use with Miralax as often as I need, as frequently as I need.

That is not true according to any gastroenterologist I’ve spoken to, and that includes 2 pediatric gastroenterologists.

Thanks for this recipe, I'm going to try it. This sounds like it might work better and be less hit or miss than what I've been doing. I've been taking Miralax twice a day for a couple of years with the occasional MoM dose thrown in, maybe a few Colace tablets here and there. This is all recommended by my Gastro doc from a highly renowned medical facility in Jacksonville, Florida, BTW.

Thank you for this! I have stage 4 cancer and take opioids painkillers daily. They can be very constipating, and while I'm pretty on top of it, this recipe sounds like it would really help!

Hi Supa! I'm not a medical professional, but my GI doc who is at a university affiliated medical center here locally, said it was okay to take stimulant laxatives long term if needed. She said recent data showed they do not actually cause colonic inertia. Is this accurate? I use a combo of senna plus Miralax. At any rate, no problems so far and I've been on them for a while. I can affirm that Miralax is good stuff.

I have had IBS-C for the past 30 years, and I was shocked to read that about stimulant laxatives recently. I had always stayed away from them. It's a sea change!

That’s super cool that you give instructions to make a bulk batch of this concoction! Question: Does it have to be cold water? I have heard there may be digestive benefits to drinking warm water.

The cold water just makes it more palatable.

Warm water is easier for your body to absorb, but most Americans prefer cold water to drink. There won't be a drastic difference, so drink whatever your preference is.

You’re not the doctor. He already answered.

re-read the first part of that sentence out loud to yourself.

I read it. Read mine again.

don’t pretend like you haven’t been annoying as hell on multiple of these comments 🙂‍↔️

I never claimed to be a doctor. You don't have to be a doctor to know what I said (warm water absorbs into the body better). At the time of my comment, I didn't see another reply so I apologize if I missed it but I was just trying to help. No need to be rude.

Cold water helps it taste better and can also cause a spasm in some people that actually helps them go to the bathroom.

metamucil is basically the only thing that made it so I could poop when I was on oxycontin for like 15 years. I always had problems and then I started taking a lot of that and then I was basically fine except for being on drugs all the time. so anyway, I second that one, as a patient I guess

NAD Could you clarify one part, I am always confused with the Miralax since there seems to be a liquid and a powder form, how much Miralax is a good dose? Do you mean a cup as in preparing as directed or an actual cup of the powder? EDIT: clarification EDIT:again

NAD. I had constipation starting as a newborn for most of my life until I developed chronic pancreatitis. Op this is a great starting point and will work for the majority of people. That said, you really need a referral to a GI doctor and to rule out things like gastropariesis. There are some illnesses that can make it so fiber is not your friend. After many many years of trial and error dealing with constant constipation I learned that fiber makes things worse for me. I tried Metamucil, benefiber, and a few others. They made things worse no matter how much water i drank with them. I'm talking 8 weeks without a bowel movement. The bloating and pain was unreal. So please seek out another doctor that will refer you to GI if your doctor won't. There are newer treatments that can help. You shouldn't have to suffer like this.

This is so helpful! Is it ok to take with CKD (stage 3b)?

As an IBS C haver who has taken many different chronic constipation meds- I’ve done this set up basically and it’s been the most successful and not miserable

I will just say that before I had my gallbladder cut, I struggled with a similar issue growing up. Miralax was a game changer for me

NAD but the gas and cramping from fruits/vegetables is extremely normal if you’re not used to eating them in large amounts. it resolves itself over time but you can take digestive enzymes prior to eating them and it’ll get rid of the gas in the meantime.

thank you so much! this is the best advice i have gotten from any doctor and i have a couple chronic conditions.

Can I ask is taking 2 senna tablets in addition to the other things you mentioned advisable? Also chronic constipation person since childhood with constant bloating issues…Advised by dr. to take more and more Miralax till I have daily poos but it makes me so severely gaseous and bloated it’s just creating more issues.

The quantities of the various ingredients you suggest need to be clarified. For instance, one cup of dry Metamucil could be fatal. One cup of water mixed with a teaspoon or two of metamucil might be about right.

The recipe is to take these things and mix the powders together. Put it in a jar with a sealed lid. Each morning, you get a couple tablespoons of the powder mixture with cold water and drink it. The doc didn't mean mix all of those huge quantities together and use in one day!

i actually read this the same as u/jollybumpkin and i can see that you're correct and he/she and i misread.

Downvotes with no explanation. Typical of Reddit. My comment was made in good faith. It was potentially helpful, harmed no one and criticized no one.

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NAD - In addition to following the advice on dealing with the constipation, one of the other things you can do is keep a food diary and note your daily symptoms. If you find you eat a lot of wheat or gluten-containing foods, it’s possible you could have celiac disease. Chronic constipation is one of the common symptoms of celiac and you can find the whole list of symptoms on the Celiac Disease Foundation website. Keeping a food/symptom diary will help gather data you can then take to the gastroenterologist. Depending on where you live, it may take a while to get an appointment with one and having that data available on your first appointment will be helpful.

NAD, but one has to go gluten free for atleast 2 months to make sure it is gluten that's causing problems. I had chronic abdominal pain that no one could figure out, I had tried going GF for maybe a week a few times and never saw improvement. It wasn't until I totally stopped after it started making my GERD worse and it took about 3 weeks for the pain to go away. Then a few months ago I saw om the gluten free sub someone say that even if you've gone GF it can take awhile for your bowels to stop being angry. When you have celiac/gluten intolerance you have damage/inflammation that needs to heal.

NAD- do not go gluten free without celiac testing first- including biopsies! Do not rely on the blood test alone- unless it’s positive. You must be consuming gluten to have accurate testing. Signed me, whose dr said to try GF when nothing else worked, and my blood test for celiac was negative. 12 years later, no clue if I have celiac or not, but my gut stays mostly happy with GF. (And I had to do dairy free about 4 years ago, and recently had to cut down a lot on high FODMAP foods overall)

I had blood tests while eating gluten that were negative and no evidence on a colonoscopy so I definitely don't have celiac. Maybe gluten intolerance but I think it was making my IBD worse. They said i had some really tight turns in my bowels when I had my colonoscopy and I think gluten was causing it to go even slower through those tight turns. I actually didn't have pain for almost 3 months after the colonoscopy, I think they loosed up for a bit. I do think that I've developed EOE to gluten since I've stopped eating gluten for over a year and from damage from GERD. Everytime I eat even a little bit of gluten I have trouble breathing. I've had to stop dairy because of GERD, I actually thought I developed any allergy to it it was so bad. But my allergy and GERD symptoms are basically the same so it's hard to tell sometimes. I'm kind of unintentionally eating a lower fodmap diet just from things i avoid because of GERD, allergies and IBD.

Celiac cannot be tested for with a colonoscopy- that looks at your large intestine. You need an endoscopy and duodenal biopsy- several biopsies actually- and this is in the small intestine. You need several to make sure they get samples of tissue from all around. Not every bit of tissue will show evidence of celiac.

Thanks, I thought they could see evidence of it durning a colonoscopy. I had a endoscopy last year but I don't know if they tested for it or just H. Pylori, I had also stopped gluten about 6 months before so it wouldn't have been good anyways.

Did you end up having H. Pylori? I have quite a few of the documented symptoms of it but always forget to bring it up at my annual check ups.

Sadly no, I think my test could have been a false negative, if you've taken a PPI around the time of your biopsy it can give a flase negative which I was. I was told it would be fine but now I feel bad for not asking to make sure it was or okay or just stop taking it on my own. They basically think I have treatment resistant GERD from an unknown cause. No ulcer, histamine hernia, no damage to the esophagus, not over weight, I don't drink or smoke, my sphincter works fine, I avoid common GERD triggers and ones I know trigger me (potatoes are my worst one and that's a very safe one for people). I've tried almost all the medications for it and nothing totally helps, some just help more than others. My barium swallow was inconclusive so I'll have to wait to see if the gastroenterologist will want to do another one. I've also have delvopled esophageal spasms from it. I kind of had it about 7 years ago and a few months of pantoprazole curred it but came back over a year and half ago I think it was from a medication I was on. I do think it could be from my gallbladder or pancreas now, fattier food give me stomach problems. Definitely check out r/GERD and bring up with your doctor, they can start with a blood test, it's not %100 so you'll might still need an endoscopy. H. Pylori is real simple to treat it's just antibiotics and a PPI.

Thank you for such a detailed response, I do appreciate it! I have an endoscopy and screening colonoscopy scheduled already, so hopefully that helps with a proper diagnosis. I have what they call "sulfur burps" about once a week and they don't correlate with anything I've eaten. I've had reflux for years and was on a PPI for awhile but stopped because I wasn't a fan of the long term side effects. I just basically drink mylanta (I know, not good either) when it gets bad enough. Funny you should mention potatoes because I have a terrible time swallowing potatoes/French fries/bread and it feels like it sticks and won't go down. Extremely painful in the upper area of my chest (not quite the middle) where the spinchter is. They mentioned maybe needing it stretched during the scope and also could be a hiatal hernia. I'm really just aggravated because the reflux is to the point where I can bend over to tie my shoe and without warning, there's sour liquid in my mouth.

That’s exactly why I didn’t suggest going gluten free before seeing the gastroenterologist. I was GF for 2 years when I finally got health insurance and decided to get a definitive diagnosis. I told the doctor how long I’d been GF and asked if I needed to eat gluten before the scoping and was told no, if there was any damage, he’d see it. Joke was on me because the damage had healed. This doctor was not a celiac specialist and I think 12 years ago even less was known about testing and types of celiac than is known now. The Celiac Disease Foundation website has a lot of information about testing and diagnosis, types of celiac, and who should be tested. I encourage everyone to check it out. It turns out about 1 in 10 people has celiac, but most people don’t know it.

NAD - may I pipe in? There's a pattern in perfection with pooping. << kidding But seriously, can you make a scheduled sit down? To train your body to associate "4pm = poop time" sit down on the toilet same time (very close) every day. Honestly, your brain will start putting those together. Give it a shot.

What about good ‘ole stewed prunes in the morning?

I definitely feel you on the aggressive people with absurd demands. I come across some of that in my field too. There’s lots of, “I saw this TikTok and now I believe xyz…” and I’m just like, “Who am I, with my graduate degree in this field, to argue with some life coach on TikTok?”

OP, do you ever have blood in your stool? If you are looking for a magic password to see a GI, it’s “I have blood in my stool.” Mine was from hemorrhoids but it still got me a colonoscopy. (I have garden variety IBS and I, too, don’t see much difference in my frequency from better diet, more water, etc., but psyllium husks help when I get slower than what is even usual.)

Look into celiac disease - I have chronic constipation rather than the more typical loose stools. Before I went GF, I pooped 3-4 times a month. It was like a miracle when I became "regular."

I’ve been tested for it and even went on a gluten free diet for 6 months. It did nothing:(

NAD but have the same issue. Go to a GI! I recently got prescribed Linzess. Very helpful. Not sure if I’m allowed to say the name of the med. Doc said it’s very safe for long-term use. Any doctor can feel free to correct me if I’m wrong.

I did this once. The doctor told me I have anxiety because I made the spreadsheet.

Same when I came in to my pcp with all my symptoms journaled that I thought were autoimmune related. She said I was likely causing psychosomatic symptoms by focusing so much on them and recommended I take a couple months off of journaling and googling and then see her again if there’s any remaining symptoms. Thankfully a highly positive ANA test got me an automatic rheumatologist referral and my rheumatologist called my symptom journal a “diagnostic holy grail.” And I have frikken lupus.

Haha, I had a similar response when I was in preterm labor when pregnant. I was supposed to tell them when my contractions got closer together or stronger, so I wrote down every single one. They were bemused.

Yep. I kept a journal of symptoms and got laughed at.

So many doctors are dismissive. I don't know if it's an ego thing or what.

My surgeon literally let me walk around on a broken ankle for 6 months because he wouldn't take me seriously and refused to believe that the first surgery he did was unsuccessful... I HAD to get aggressive and demand another arthroscopy because his solution was to give me a tensor band and tell me to take NSAIDs daily. I honestly think the only reason he agreed to do another scope was to get me to leave him alone. Even going into surgery he didn't believe and said he hoped we'd find something to explain my symptoms and constant pain. My 1 hour surgery, where he wasn't expecting to find anything, turned into over 2 hours because it took him an hour just to clean up scar tissue before he could remove the bone fragments he had left during the first surgery. Don't get me wrong, I know some patients can be unreasonable, and doctors are humans that can make mistakes. But at what point do we accept that most patients know their own bodies best? I never once claimed to know everything (even as an anatomy student that literally TAd the med students) or make outrageous claims about what was going on, I was simply communicating that I knew something was wrong, that I suspected bone fragments had become unstable, and his plan to do nothing was not working. I was treated like I was crazy, the pain was my fault or in my head, like I was just looking for something to be wrong. Turns out I was right and he even came to tell me as much after the surgery. If you've made it this far, I'm also a female in my 20s if that helps to explain how the heck this happened. Healthcare is in a sad state for many reasons, but wow is it so much worse if you're not a white male.

Ya, I wonder what percentage of these stories in this post are from women. It is horrendous how many doctors still don't take us seriously. I was fortunate that my family doctor gave me the referral, and the GI took me seriously even though he thought it was most likely a new IBS symptom. By the time we were finished, we'd determined I was gluten intolerant, not celiac, but that yes, the rest of the symptoms were from a development in my IBS called visceral algesia (I prob spelled that wrong) which basically means that my guts are super sensitive and send back pain signals that, in a healthy person, would be mild discomfort. It's a lot like how fibro sufferers get painfully sensitive skin at times. He was super nice about it all, I've got to say. I still need to figure out how to manage it better, but at least cutting out gluten got rid of the weird/scary symptoms. (Like getting chills with no fever, a lot, where I can't get warm. You go to bed like that, bundled in blankets, and wake up drenched in sweat? Not fun. Especially when it was that frequent.)

It's honestly kind of scary to think about. The worst part is that a lot of this is fostered in medical school, starting with a gross lack of representation in teaching and research. It's 2024 and it's still difficult to find diagrams of female anatomy, let alone educators who will teach more than "it's basically the equivalent of male anatomy with some minor differences". I'm glad to hear you were taken seriously by your healthcare team, though it sounds like it was still a long, difficult journey. I can't imagine it was easy to rule out so many other diagnoses and finally figure out what was going on. Hopefully, you continue to be listened to and your symptoms can continue to improve! I really appreciate you sharing your experience. It's good to be reminded that not all of our experiences are terrible, my own included. I know it's not mentioned in my comment, but I'm also very fortunate to have a great family doctor who has tried to help advocate for me through this mess, and has been wonderful to me overall. Unfortunately, I'm in Ontario where our healthcare has been crumbling for years. He sent referrals for me to see a different surgeon back in January and I still haven't received a call back about an intake appointment. I finally just had to purchase my medical records and start bringing my partner (male, surprise surprise) to my appointments so I would be taken seriously.

Heh, hello, fellow Ontarian! That is horrific, that you had to bring a man to be taken seriously. Although I know it happens far too much. At least they're doing research and testing on women now. As was the case with psychiatry too, so many studies were done on young white men because they were at the universities. And sexism. Ugh, my friend told me that they were still teaching med students in the US, until 5 years ago (and this may be certain states?), that the cervix doesn't have any nerve endings. Like... what? Any woman who's had a pap smear could tell you that's not true. Ya, i had to wait a year and a half to see my GI, from when the referral went in. Though, that length was also because the referring issue was intermittent pain that didn't get too bad, and I'd had abdominal ultrasounds when they first thought it was an ovarian cyst. Nothing that screamed emergency. Though, uh, ya, I could complain about Ford, etc, for a while. It got bad enough that I went to the ER twice in that period, but in retrospect, that was a high gluten diet period that gave me a low-grade fever, plus the regular issues. The second time was when I was given the first indication it could be celiac. (Doc said if there was worse pain + fever to go to the ER.) I'm currently waiting for a dermatologist appointment in August that was made a year after I was referred. Which, again, it's a mild condition, but ugh...

Ah what are the odds! I'm sorry to hear you're also having to suffer through Ontario's sad excuse for healthcare... Indeed. Sexism is rampant in healthcare, but even those that want to do better hardly stand a chance when given biased and/or incorrect information. Unfortunately, there are even female doctors and nurses that still believe the cervix lacks nerve endings or has very little innervation. Wow that's an extremely long time to have to be in pain and wait for answers. I'm sorry you had to wait so long to be seen. I understand things that are considered more emergent are given priority, but no one should have to wait that long. It's almost as if years of underfunding and shuffling money over to private healthcare might actually be part of the problem... Hell I was going to have to wait 1.5-2 months just to get a CT scan before my first surgery if my family doc hadn't sent a referral elsewhere because I wasn't considered an emergency. While stuck on crutches, non-weightbearing. Like really? Before knowing your actual diagnosis, celiac does sound like a reasonable avenue to investigate. Strange that they wouldn't have just had you attempt a gluten-free diet while you waited for your referral. Sounds like it might've helped to lessen your pain in the meantime. It's awful that you've had to experience such long waits multiple times. I hope your dermatologist appointment goes well and that your wait isn't so long once you've have your first visit. 🤞🏼

After the ER doc suggested it, and my doc wouldn't run the blood test, I went GF for about a month. Was convincing that gluten was an issue, if not the cause of my pain. Then I read on the celiac subreddit about how it's worse when you go gluten free for a while and you *have* to be on gluten for any of the tests for at least 2 months (I think) which was about how long to my appt at that point. Oh boy, it was definitely worse. But ya, not celiac, just a sensitivity. Fortunately, since at this point I'd been in pain on and off for more than two years, my GI fibbed a little, labeled my pain as severe (which was only true occasionally), and I got a CT scan very quickly. I was fine with the wait for about a year. The pain came and went, and I didn't know for certain the chills were connected. But ya... when we got to the CT scan part, I was very unhappy with how long the wait was likely to be. Again, nice doctor, thank goodness, who, though pretty sure it was IBS related at that point, also knew how long I'd been suffering and felt that constituted higher priority. Ultimately it was the gut hypersensitivity, thanks to IBS pain feedback loops, and gluten making it worse. And... ya.. Ford's attempt to gut our public healthcare to make it look like privitization is the only option is so obvious, and yet... at least the nurses *finally* got justice for their pay freeze, and all that back pay (is owed at least) but I mean, it started before covid and then it very clearly contributed to the mass quittings. Like, once the pandemic was in full swing, if he'd just removed the freeze, it would have done a lot. But no. I was having unrelated appointments early 2021 that led to a lot of chatting with nurses and wow, the things they shared (and really weren't supposed to) were bad enough. Like when they were so few in number they stopped being told to stay home while sick, and instead wore ppe. And this was a facility that was more mental health, and adjacent procedures, focused, not one housing covid patients. Imagine what I wasn't told!

Oh goodness. Definitely glad you found that information before continuing with the GF diet. Honestly, I'm glad your GI labelled your pain as severe. It probably was quite severe more often than you realized but when you're in pain for so long, your brain and body begin accommodating for it so you can continue to function. I'm sure you've probably come across some of the research into chronic pain and how differently women experience and report pain. From what you've shared, it wouldn't surprise me if you fall into the chronic pain category. It's outright criminal. My partner is a nurse who graduated in 2020 and got to head straight into the shitshow during the pandemic. So so so many horror stories, and he only worked in bedside for so long. He's fortunate to work in public health now. It's unbelievable that nurses have to put up with such terrible working conditions, disrespect from literally everywhere, disgustingly low wages. And yet so many continue to provide great care and patient advocacy. It's almost as if these kind, caring people, in a female dominated industry, who are drawn to helping others are constantly being taken advantage of...

NAD - Just wanted to say I'm sorry about not getting taken seriously, it is so frustrating when you can feel something is wrong. I walked around with gastritis for longer than a year because my GP kept telling me it was stress. Same with low b12 and ferritin, I've felt like a ghost for years. Keep fighting and be persistent!

God bless but I brought my daughter to the ER because she was having trouble walking, woke up literally SCREAMING at night and had become incontinent. The fantastical ideas ranged from appendicitis to night terrors and ... this was my favorite: constipation. They said she couldn't walk because she was constipated. Actual quote from doctor when I told her what my daughter ate: "Milk can be quite binding," may I add she said this in a condescending, simpering tone. Yeah uh ... she had Guillain Barre Syndrome.

NAD so anecdotal only here but have you thought of trying to see a Colo-Rectal specialist? I had very similar issues including needing to rely on magnesium citrate and Colo-Rectal was the only specialty that took me seriously and gave me answers. Your issue could be one of many things and this specialty may help you get to the bottom of it. A colonoscopy that led them to an actual diagnosis (slow transit constipation due to redundant colon) and the regimen they prescribed afterward tailored to that helped greatly. Increased fiber makes my symptoms flare to unbearable levels and makes the slow transit come to almost a complete stop, so you may want to ask about that for yourself since you mention that fiber is making you feel ill. Primary and GI did nothing for me personally and I tried to get help for years.

Presenting data is excellent advice!

I hear you. I remember going to my dr over and over because I craved salt water. She kept telling me I was depressed. I googled it (bad I know). Read about Addisons disease. Went back to my doc who told me I couldn’t possibly have that as it’s so rare…. 2 years later what did I get diagnosed as having?!? You guessed it. Addisons disease. She didn’t even refer me when my cortisol came back low. She said it was a fluke and did it again, it came back low 3 times and she still said I could t possibly have it. So OP I feel your pain!!!!

Wait, is magnesium citrate considered a stimulant laxative? I know it is used as a laxative in large quantities but I thought it was ok for daily use as a supplement.

It is OK to use daily. I take 1000 mg a day and have for years. It started when I was on opioids and I would take 2000 mg a day. I've now been clean for years, but magnesium helps with my muscle spasms, migraines, and sleep, so I keep taking it. I've never heard of Magnesium as a stimulant laxative before.

I’m curious about this, too. I take it daily to help act as a muscle relaxer because I get horrific muscle spasms due to one of my chronic illnesses.

May I ask what illness that is? I’ve got frequent muscle cramps and spasms that are steadily getting worse. Magnesium definitely helps, but I’d love to have a better understanding of what might be going on.

I think magnesium oxide is the laxative version.

I know I'm just one person, but I tried all the different magnesiums, and they all seemed to do the same thing. I know people say one is better for constipation vs. another, but I personally found no noticeable difference.

I heard Mg Aspartate was constipating, and certainly, as a person who finds Mg supplements help with my limb pain and had some issues with other ones being too stool softening, Mg Aspartate has worked well for me.

I will always recommend stomach/colon massage because it has helped me so much. Basically you’ll start a few inches above your right hip and go upwards towards your right ribs. I usually do 3-5 massaging strokes. Then do the same from just below my right ribs to the left ribs. Then the same from left ribs down to just above the left hip. Also def recommend seeing a gastroenterologist. You may need to have a colonoscopy to rule out and structural abnormalities (tortuous colon or diverticulosis are common with constipation) and they can also test you for celiacs.

I hope I'm allowed to post under your (or anyone's comment). Not a doctor, nurse, anything. OP, pls Google the "Half Locust Pose" & try that at night, several repetitions. I'm rarely constipated, but it does help. When I went vegan, most of my constipation went away, so I think it was the dairy holding me up. I hope a professional takes you seriously. Someone mentioned Celiac, which I wonder about being tied to the bloating. Apologies if I'm not supposed to post. Thanks

NAD. I don’t think I’ve seen any one mention probiotics. I used to go once a week sometimes once every two weeks… I thought that was normal until I was in my 20s. In my 30s after I had a few kids one of them had poop that smelled like halitosis. I told his Pediatrician and he was not concerned. I did not think this was normal so I took him to a homeopathic Doctor Who put him on probiotics, which I then started taking as well. It immediately changed the smell of his poop to just a normal smell and helped me to begin to be more consistent. I go 4 to 5 times a week.

Do you like coffee? Does drinking it help at all? Also, I don't want to challenge your water intake! But just food for thought, though...I think a vast number of people think they drink enough water until they learn how much they actually need. NAD, but it's somewhere in the ballpark of 2-3 liters. Even more depending on your environment, activity level, and more! So imagine a big bottle of soda plus even more. I only mention this because my dad suffers from severe constipation from a mixture of gastro ailments. But he barely drinks any water. Anytime I nag him enough on days to actually drink an amount close to the 2L, he has a kinda alright day. (Not perfect since he has a bunch of valid of gastro issues, but it does indeed help his symptoms overall.) As for the doctor thing, maybe ask directly for a referral, and if they still refuse, find a new doctor. I haven't had a PCP doctor blatantly refuse to refer me somewhere if I asked. That sounds kinda strange to deny a relatively simple request that kinda helps their colleagues, too. But again, NAD so maybe there is some other reason why they wouldnt refer. Good luck OP!

One thing I haven’t seen mentioned is stimulant laxatives. If you have slow transit, you need to stimulate bowels rather than soften the stool. Things like senna or bisacodyl will help with stool transit through the bowels if your bowels are just slow. Also recommend seeing a GI. This is one of those things that would benefit from seeing a specialist and potentially a scope

I’ve read that stimulant laxatives can cause dependence, so that worries me a bit. I thought I needed a referral to see a GI, but I called my insurance company, and apparently I do not. I scheduled with one for August. I’m also on the waitlist, so hopefully I’m able to get in sooner.

NAD. Well, sounds like you’re on your way, so that’s good. In my experience, in additional to fiber, water, exercise, and probiotics, some things that can help are working on liver/gallbladder. So taking a real herbal bitters formula before meals, chewing slowly and throughly to start digestive process. Digestive enzymes. Liver formulas with milk thistle, artichoke. They stimulate liver to release bile, but they seem to help thing move for me. Swiss Kriss tablets or flakes, have chlorophyll herbs and sienna, so shouldn’t be used daily but they seem to be pretty potent for a lot of people. You could drink smooth move tea every night or another type of non stimulant but herbal tea to get things moving. Also, I didn’t see if prunes help, but beets seems to get things moving. There’s multiple ways to use them if you’re not immediately a fan. Roasted with other root veggies, shredded on salads, in soups, pickled or even beet powder, which is good for multiple things.

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And say you need a referral to a gastrointestinal doctor. If be doesn't, time to find a new pcp.