I've had severe constipation for as long as I can remember. My mother had it, and her mother had it too. I have no idea what causes/caused it. I've given up trying to understand it. All I know is that mine responds very well to osmotic laxatives. Miralax works very well. But, if I don't take it every few days I go right back to straining my eyes out. I'm currently having sustained success for the first time in my life however. The success began when I did a 14 day course of Xifaxan-550 to treat SIBO (if you have chronic constipation, SIBO is pretty much a slam dunk). The day before starting the Xifaxan I took 3 caps of Miralax, and really got things moving. I then started the Xifaxan and switched my diet to incorporate more "low fodmap" veggies and fruit. In the past I always avoided high fiber foods because they made my constipation worse. I also switched to Magnesium Oxide and switched to squatting on the rim of the toilet rather than sitting. It's like a poor man's squatty potty. So here is what my daily routine looks like now: Wake: 7am - Drink 16 ounces of mineral water (Grolsteiner or a brand with plenty of sodium and magnesium) and a cup of black decaf coffee. Go squat on the rim of the potty until I have at least a small BM. I give it plenty of time. I usually have a pretty decent size BM after a few minutes, but not always. You just want to get something going. Anything. Even if it's very small. Breakfast: Vitamin C (1000mg), 4 bacon, 2 eggs w/diced tomatos, slice of papaya, grapes, 1 navel orang [After breakfast I usually now have a large BM. Sometimes 2.] Lunch: Vitamin C (1000mg), kale/cucumber smoothie (kale, skinned cucumber, 3 ounces of aloe, fresh pineapple, 1/2 cup of cocounut water in blender on high for a few minutes. Needs to be liquid smooth.), 4-5 ounces of chicken, white rice with ghee, 1 naval orange, canteloupe Dinner: 1/2 pound of ground beef with diced tomatos, green beans, romaine salad with sesame seeds, olive oil, raisins, and red wine vinegar, yellow squash fried in grapeseed oil with good mineral salt, 1 naval orange, papaya Bed time: 400mg of Magnesium Oxide, bowl of strawberries, canteloupe or watermelon Things to point out: The Xifaxan clears the initial SIBO that exacerbates the motility problems, but I think taking the miralax to get things moving initially really helps the Xifaxan to work. I also drank a lot of high fat, homemade chicken bone broth during the Xifaxan treatment. Sometimes I would just have that for dinner instead of a meal. Slowly transition to more veggies as the 14 days pass. A little more each day. You'll also notice that this diet is gluten free, dairy free, nut free and low fodmap. I throw in some restistant starch foods like white potato every now and then in tiny amounts just to test the waters and keep those RS loving bacteria kicking a bit. Not sure if it even helps or not. I just do it. :-/ Having plenty of vitamin C and citrus fruits throughout the day helps things a lot and won't trigger SIBO symptoms. Plus, eating the whole fruit doesn't spike your blood sugar like just the juice would since the fiber is still there. I try to have at least one smoothie per day with aloe. Sometimes I have two. It really seems to help things keep moving and give digestion a breather. Eat papaya and pineapple with every meat containing meal since they contain a ton of natural enzymes and will really help keep the food from sitting in your stomach/duodenum for hours. Only drink good, high content mineral water and keep it around 24 ounces a day. If you drink too much you pee out your electrolytes. If you drink to little you get dehydrated. I found that 16 ounces upon waking, and another 8 ounces between meals is all I really need. Just don't drink too much and keep it high quality. No tap water. The magnesium oxide before bed works well. Right now 400mg is working ok for me. You may benefit from more or less. I keep an extensive daily food journal so that I if I have trouble getting a BM going in the morning I can turn back a page or two and see what may have caused it. This is also helpful with the smoothies. WHen you make a smoothie that's heavily loaded with kale it will turn your poop spinach green. You can use this as a natural way to track your transit time. Drink a big kale smoothie for breakfast and dinner one day and then see how many days it takes for your BM to come out green. This tells you your transit time. Then, you can use the transit time going forward to figure out which foods you ate might have brought back your constipation. You'll know how many pages back to turn in your food journal. On the occasion that I do have a hard time getting a decent BM, the next two mornings I'll use 1/2 a teaspoon of Effer-C mixed well in 8 ounces of clear water (spring water, not tap). Then chase it with another 8 ounces of clear water. By the second morning of this I'll have a large BM and be back to regular. Then just go look up in your food journal what may have been the culprit. A note on low fodmap food lists: Most low fodmap food lists out there are a little off. I'm not sure why, but they include foods that are pretty highly fermentable. The list I use is from this book. I choose foods from the appendices that are listed as "low" on the symptoms chart.