@georgemorley - understood. I would hope that going into the future, your doctor would come to a firm diagnosis for you, so you can fully understand what is going on with your body and the mechanisms you are using to address it. A diagnosis would also help to be sure you are chatting with others on Mayo Clinic Connect who have situations the very most similar to yours.

I am not a medical professional by any means, but for instance, here are a few examples of things that can cause constipation:

- Irritable bowel syndrome https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016 You'll note this article has this to say about the types of IBS: For the purpose of treatment, IBS can be divided into four types, based on symptoms: constipation-predominant, diarrhea-predominant, mixed or unclassified.

- Hypothyroidism (underactive thyroid) https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

- Intestinal obstruction https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-causes/syc-20351460

What are your thoughts about asking your doctor if any of these or other diagnoses might explain the chronic constipation you've had to deal with?

@georgemorley I thought it was worth a try. Other than diarrhea, there don’t seem to be other problems and that is hopefully managed by stopping it or reducing dosage. Someone in discussions suggested to be sure to drink water with it to help effectiveness. Also attend to guidelines to not eat or drink anything for a while after taking it.
I take it on waking up with two glasses of water and wait for an hour before eating or having coffee etc.