@cezanne My story is not unlike yours. Linzess doesn't work for everyone. Hopefully prucalopride will be better for you.

I have pathologically slow transit due in large part to dysautonomia. I recently took a breath test that my GI doctor ordered and I tested positive for intestinal methanogen overgrowth (IMO). Slow transit creates the opportunity for IMO, and in turn the methane produced in the gut as a result is known to slow transit even more. It can be a vicious cycle.

Consider asking your doctor if a breath test would be appropriate. Mark Pimentel, MD, at Cedars-Sinea is leading the research on small intestinal overgrowths and has said that in many cases IBS-C is actually a manifestation of IMO.

BTW, I haven't noticed that Linzess significantly altered my electrolyte balance.