Dr.GutHealth said:Fiber trials in this population are thin, and most of what gets quoted is extrapolated from idiopathic constipation in people eating normally.
Acid reflux and constipation: I developed GERD symptoms around week 3 that I'd never had before. The delayed gastric emptying means food and acid sit in your stomach longer.
Management that works for me: elevate head of bed 6 inches, don't eat within 3 hours of lying down, avoid trigger foods (tomato, citrus, spicy, chocolate), and famotidine 20mg at bedtime. Much better now.
A narrower follow-up, since the general answer is now clear:
What the mechanism is, because if it is transit rather than water then fiber is the wrong lever?
quinn_sf said:Acid reflux and constipation: I developed GERD symptoms around week 3 that I'd never had before.
Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for hours after a small meal.
Tips: eat your protein FIRST (most important macro), then vegetables, then carbs last. Chew thoroughly — 20-30 chews per bite isn't excessive. Avoid carbonated beverages with meals. If symptoms are severe, your doctor may recommend a gastric emptying study.
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Water and magnesium first, soluble fiber second, and dropping the bran entirely. Resolved in about a week after two months of getting it backwards.
hyun_seoul said:Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for…
Gastric emptying studies and constipation: semaglutide delays gastric emptying by ~40% at steady state, as measured by acetaminophen absorption testing and scintigraphy[1].
Clinically relevant implications:
- Explains early satiety and nausea
- Affects absorption of co-administered oral medications
- Creates aspiration risk for procedures under anesthesia
- Contributes to constipation via slowed GI transit
Importantly, the gastric emptying delay attenuates with continued use (tachyphylaxis), which correlates with the transient nature of GI side effects.
[1] Blundell J, et al. Diabetes Obes Metab. 2017;19(9):1242-1251.