pete_manc_UK 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.
andrew_nyc said:Constipation replaced nausea at around week five and has been the more persistent of the two by a wide margin.
Heartburn management on constipation: Tums as needed 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.GastroMayo said:Worth saying plainly that not all of this is benign.
Gastric emptying studies and constipation: semaglutide delays gastric emptying by ~40% at steady state, as measured by acetaminophen absorption testing and scintigraphy[1].
Clinically relevant implications:
- Explains early satiety and nausea
- Affects absorption of co-administered oral medications
- Creates aspiration risk for procedures under anesthesia
- Contributes to constipation via slowed GI transit
Importantly, the gastric emptying delay attenuates with continued use (tachyphylaxis), which correlates with the transient nature of GI side effects.
[1] Blundell J, et al. Diabetes Obes Metab. 2017;19(9):1242-1251.
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Browse GL BiochemOne thing that is still open after Dr.NephBHM_UK’s answer:
What the mechanism is, because if it is transit rather than water then fiber is the wrong lever?
OP back with an update, since a thread like this is useless without one.
Resolved: water and magnesium first, soluble fibre second, bran gone entirely. Two months of doing it in the wrong order and a week to undo.