Constipation: The Boring Levers Work, PEG Is the Safe Workhorse, and Most Laxative-Addiction Fear Is Outdated

Summary

The unglamorous levers genuinely work and the scary folklore is mostly outdated: soluble fibre (psyllium ≥10 g/day for ≥4 weeks) raises stool frequency by roughly 3 bowel movements a week, adequate fluid and regular movement help modestly, and an unhurried morning toilet routine that respects the post-meal gastrocolic reflex and the urge is free; when those aren't enough, **PEG (an osmotic laxative) is the safe, effective, non-habit-forming long-term floor** — the daily workhorse guidelines strongly recommend for ongoing use — while **stimulant laxatives (senna, bisacodyl, sodium picosulfate)