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Evidence-based GLP-1 & peptide discussion since 2023
ForumsSide Effects & ManagementHas anyone dealt with delayed gastric emptying?

Has anyone dealt with delayed gastric emptying?

rachel_ABQ Thu, Jan 9, 2025 at 3:14 AM 5 replies 1,586 viewsPage 1 of 1
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rachel_ABQ
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Jan 9, 2025 at 3:14 AM#1

Collecting this in one place because it comes up every few weeks and the answer is always assembled from scratch. It is about constipation and the lower-GI picture, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

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.

The condition it depends on

One important qualification: fiber without adequate fluid is worse than no fiber. If intake is down, fluid is usually down too, and adding bulk to a dry system is how people end up in real trouble.

The practical version

Soluble versus insoluble is the distinction that matters: psyllium and oat beta-glucan hold water; wheat bran adds bulk. On slowed transit with low intake, the first helps and the second often does not.

What I am not sure about

What would genuinely help is knowing whether fiber actually helps GLP-1 constipation or whether the evidence is borrowed from a different population. Numbers rather than impressions, if you have them.

— rachel_ABQ · corrections welcome and will be edited into this post with credit
42 12nick_newbie, DadBodDave, AmyNC_wife and 39 others
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RetaRick_CA
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Jan 9, 2025 at 3:49 AM#2
rachel_ABQ said:
The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.

No disagreement with rachel_ABQ. One condition attached. 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.

41 11AmyNC_wife, SkepticalSean, Dr.CardioMD and 38 others
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MikeFit_NJ
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Jan 9, 2025 at 4:24 AM#3
rachel_ABQ said:
The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.

Worth saying plainly that not all of this is benign. Severe constipation on delayed gastric emptying has produced obstruction and ileus cases, rarely but genuinely. Pain with vomiting and no bowel movement is not a fiber conversation.

40 10DeniseRN_TPA, SandraNC_45, Dr.EndoIndy and 37 others
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lisa_labSD
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Jan 9, 2025 at 4:59 AM#4

Short answer first, then the reasoning. Fiber trials in this population are thin, and most of what gets quoted is extrapolated from idiopathic constipation in people eating normally. The extrapolation is not unreasonable but it is an extrapolation, and it fails specifically for insoluble fiber at low intake — the case that comes up here most often.

Happy to go further on any of that.

39 9lori_vegas, Dr.PulmRoch, maya_sedona and 36 others
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tampaLisa73
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Jan 9, 2025 at 8:15 AM#5
RetaRick_CA said:
The escalation order that reflects the mechanism: water and salt first, then soluble fiber, then magnesium or an osmotic agent, then a stimulant only…

Same pattern here, and in the same order. The detail I would add is minor and it is already implied above.

38 8TomFromTexas, mike.trainer_LA, sarah_nash92 and 35 others
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