Feedback on Linzess for Irritable Bowel-C or Chronic Constipation

@bb4eternity
Thank you for getting back to me. Very nice of you.
At least none of us who use this forum have to deal with this subject alone!

Hi @cezanne - just wanted to touch base and see if you have had your colonoscopy and endoscopy? How did the prep go?

@lisalucier Hello, thanks for thinking of me. The endoscopy went well with no abnormalities noted but pending biopsy results.
As I feared, even the two day prep did not clear me out for a satisfactory colonoscopy. Upon informing me right after, my GI doctor who performed it suggested we try again the very next morning upon my doing another prep that night. I managed that and the second colonoscopy was successful and looked like probably normal. Thank goodness. I meet with him in early Feb for a full report.
Normal procedure outcomes are welcome and may be one step toward figuring out what are the cause of my symptoms as I continue this journey.

@cezanne
You have a very nice doc!!

Hi there, I was on linzess it might be the dosage, what mg is your linzess?

@vincentjr Hello, I was started on the lowest dose, 72 mcg for two months, no changes at all. Then we tried the larger dose 290mcg which going into second month late summer '25, no discernible change in chronic constipation or bowels. I have continued it to date. I am curious what is the longest time one could expect the Linzess to start making a difference? I am also curious if the Linzess can help with other abdominal discomfort systems?

I have other issues: silent reflux and hiatal hernia. Sometimes where I imagine my stomach is, I have a sense of fullness to the point where I don't want to eat (lost about 15 pounds in a year), rarely also mild nausea. I am fairly careful with what, when, and how much I eat under usual reflux guidelines. Fiber aggravates everything and I have to be careful with that.

In the interim, still continuing the 290 mcg, not long after colonoscopy and upper endoscopy (could be a coincidence) for a few weeks now I have had diarrhea, mostly controlled. I stopped the Linzess just in case and after a week went back to the 72 mcg every other day. I didn't see any changes. Possibly because of the diarrhea I have less discomfort associated with the constipation so ironically feel better because of that and of course, no laxatives needed.

This group has been a solace and when I see the more severe and big lifestyle changes members endure I appreciate I am managing OK and I wish all relief.

I see my GI doctor in a few weeks.

@cezanne To follow up after meeting with the GI Doctor after normal colonoscopy and EGD, biopsy. He diagnosed IBS and to continue with Linzess for other benefits than noticeable relief from chronic constipation. I now see my IBS is the cycle of Constipation and diarrhea each at intervals of weeks.
Anyway it was a relief that nothing dire was found.
Here is the kicker: he never explained what IBS was, what possible prognosis is, and what lifestyle changes might help. He seemed OK with whatever regimen I use to deal with my symptoms (so far stimulant and softener types).
I remain at a manageable level and only a few times unable to leave the house because of diarrhea. Right now I am managing OK, trying to read credible sources a diet etc and balance with my hiatal hernia and silent reflux.
I just wanted to follow up.
Greetings to fellow sufferers.

@cezanne I too was diagnosed with IBS which confused me as I thought IBS caused diarrhea which I do not have. Learned there are 2 types, IBS-D and IBS-C. I have IBS-C and have been on 290mcg Linzess daily. While the first week it caused diarrhea, it has settled and now I am fairly regular. Stool is still a bit loose with some solid but regular. There are still foods that can flair stomach pain and nausea which I have noted to avoid. Also, not eating a meal later than 5PM has helped. I don't skip the Linzess and make sure to drink LOTS of water with it. I also stopped taking Benefiber and other stimulants as I read not to take them with Linzess. I hope you find a balance that works for you.

@bb4eternity Thank you for your information. It is trial and error. Fiber worsens constipation for me. Like for you, diet and lifestyle modifications help. Most days my main and last meal is ideally before 3pm. Small meals are important. Lots of water is a key as you indicated. Modifications for silent reflux often help with IBS although what is helpful for one may not always be helpful for the other. It is a roller coaster but right now I am in a holding pattern which is acceptable.
For what it’s worth a routine for me is after eating breakfast and coffee ( an indulgence) I visit my friend the toilet, elevate my knees with a stool, and do easy breathing. A massage therapist told me the breathing helps the vagus nerve which plays a role in GI matters. Sometimes I read. Surprisingly even if initially I did not have an urge, a rarely impressive BM occasionally occurs. I’m grateful for any success.
Weather permitting I also walk 15 minutes which I think helps. I am 75 and otherwise in decent health. No other prescriptions than Linzess and glaucoma drops. other stuff: probiotic, multivitamins, Berberine for microbiome, and trying Thorne brand “Entero Mend”. Nothing so dramatic in effect to say what’s helping.