sophie_paris said:

Fiber trials in this population are thin, and most of what gets quoted is extrapolated from idiopathic constipation in people eating normally.

Genuinely useful, thank you. I had the facts and not the framework. I will report back once I have actually tried it.

From the other side of the consultation, briefly.

Sulfur burps on constipation — the most underrated side effect nobody warned me about. 🤢 The smell is absolutely vile and comes on without warning.

What finally helped: Pepto Bismol before meals. Also, eating smaller portions and chewing thoroughly reduces the gas production.

If sulfur burps persist beyond 2-3 weeks, talk to your provider — it could indicate gastroparesis that needs medical attention.

NurseAsh_DET said:

Heartburn management on constipation: Pepcid (famotidine) 20mg has been my savior.

Acid reflux and constipation: I developed GERD symptoms around week 6 that I'd never had before. The delayed gastric emptying means food and acid sit in your stomach longer.

Management that works for me: elevate head of bed 6 inches, don't eat within 3 hours of lying down, avoid trigger foods (tomato, citrus, spicy, chocolate), and famotidine 20mg at bedtime. Much better now.

SallyK_inj said:

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

Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed gastric emptying. My TSH drifted up after starting semaglutide.

Solution: take levothyroxine on an empty stomach, 60 minutes before any food, and have your TSH rechecked 6-8 weeks after starting or changing GLP-1 dose. My endo had to increase my Synthroid by 12.5mcg.

Moderator note: reminder that nothing in this thread is medical advice, and that clinical claims need a source. Thread quality here is what the rules are for. Keep it up.