traveltech_sara 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…
That reframing is the part I needed. Adding it to my notes with a link back to this thread.
From the other side of the consultation, briefly.
Heartburn management on constipation: Pepcid (famotidine) 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.
Dr.PulmRoch said:Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for…
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.
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Browse GL BiochemDr.GastroMayo said:I added fiber, made it noticeably worse, and only later worked out that I had added the bulk without adding the water.
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: Gas-X (simethicone) daily. 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.
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