Please see my solution for constipation from @farmersmith It has worked for over a year with occasional back ups of coffee and Smooth Move

Here’s a quick and easy exercise routine for strengthening your pelvic floor muscles:
Sit comfortably on the floor with your knees shoulder-width apart. Imagine that you are trying to stop yourself from passing gas, and squeeze the muscles around your anus as tightly as possible. Hold for five seconds, and then release and relax for a count of 10. Repeat this process five times.
Now do the same thing, only at half strength.
Repeat this process five times.
Finally, squeeze and release the muscles tightly and quickly for as many times as you can before you get too tired to continue.

Practicing deep breathing is another easy way to help improve your digestive functioning and relieve any stress that may be contributing to your constipation. The great thing about deep breathing exercises is that they only take a few minutes and can be performed virtually anywhere. This quick deep breathing exercise is called the 4-7-8 technique:
Sit in a chair with your back straight and your hands resting comfortably in your lap. Breathe out through your mouth, exhaling completely. Close your lips and inhale through your nose for a count of four seconds. Hold in your breath for a count of seven seconds. Exhale completely through your mouth for a count of eight seconds. Repeat these steps three more times for a total of four complete cycles.

Breathing: breath in blowing up your diaphragm but not raising shoulders or chest breath out with mouth open in oval or through hand or spread lips. Don't huff and bear down for BM

Hi @gbear1953, I am reading through your comments and must say I really do relate to your wife’s all-things-constipation. This is an absolutely exhausting process for both of you!

I understand you are at a place that surgery is your only option. I also see your comment that her issue is pelvic floor dysfunction. In another comment you described her muscles not working the correct way. I struggled addressing my constipation (and much broader) issues for some time. Once I landed with my current providers they did an anorectal manometry test with the exact results, I had coordination problems where my muscles worked backwards. I didn’t understand any of it at the time but they were adamant that nothing else would work without addressing this problem first. That set the stage for progress, slow but steady. I am doing better.

I apologize if I am asking your to repeat but I am not seeing, and certainly not wanting to minimize the severity of the challenge your wife is facing.

Have you addressed the pelvic floor dysfunction?