Short answer first, then the reasoning. The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work. Less food means less bulk, slower motility means more water reabsorbed, and the result is a smaller, drier, slower stool. Insoluble fiber adds bulk to a system that is already moving slowly, which is why it frequently makes things worse. Soluble fiber holds water and is the better first choice, and an osmotic agent works with the mechanism rather than against it.

I would rather be corrected than agreed with, if it comes to it.

InsuranceTom said:

The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.

Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for hours after a small meal.

Tips: eat your protein FIRST (most important macro), then vegetables, then carbs last. Chew thoroughly — 20-30 chews per bite isn't excessive. Avoid carbonated beverages with meals. If symptoms are severe, your doctor may recommend a gastric emptying study.

paige_pharma said:

Constipation replaced nausea at around week five and has been the more persistent of the two by a wide margin.

Can confirm the pattern paige_pharma describes. The escalation order that reflects the mechanism: water and salt first, then soluble fiber, then magnesium or an osmotic agent, then a stimulant only briefly and only if the osmotic has failed. Stimulants first is the commonest error and the one most likely to end in a cycle of dependence.

Adding the clinical framing, because it changes how the question reads.

Heartburn management on constipation: omeprazole 20mg has been my savior. The delayed gastric emptying means stomach acid just sits there.

Don't ignore persistent heartburn — chronic acid exposure can damage your esophagus. If OTC remedies aren't cutting it after 2 weeks, see your doctor for something stronger. You shouldn't suffer through this.