I’m looking for experiences with medications for slow gut motility, especially when it’s caused by medication. I'm on Nortriptyline 50mg, which slows your gut motility down resulting in constipation. I’ve had chronic constipation since I was a kid, and no amount of diet or exercise has ever fixed it. I’ve been on Miralax and psyllium husk my whole life just to function.
After starting nortriptyline about 2 years ago, my constipation got significantly worse.
I’ve tried both Linzess and Trulance:
• Linzess: gave me frequent gas and bloating and mostly just small, mushy partial bowel movements. I also really disliked the “active window” effect and eventually stopped working.
• Trulance: worked a bit better at first and gave me soft, easy-to-pass stools for a few weeks, but then it also stopped working.
Right now, if I combine Trulance with daily Miralax, I can get soft but formed stools 1–2 times a week, but the rest of the time it’s small pebbles. My main issue doesn’t seem to be stool consistency. It's more motility and movement.
My goal is a daily or every-other-day solid, easy-to-pass bowel movement with minimal gas and bloating. I asked my GI about trying Motegrity, but he wants me to try Ibsrela first. He also thinks I have pelvic floor dysfunction from years of straining and chronic constipation and poor coordination / loss of normal urge signals. He recommended starting pelvic floor physical therapy since he thinks mine is too tight.
I’m curious if anyone here has had a similar situation:
• medication-induced slow motility
• constipation that didn’t respond well to Linzess/Trulance long-term
• pelvic floor dysfunction and whether PT actually helped
Any experiences, medication suggestions, or tips would be really appreciated.