Education only. Not medical advice.
Work with your clinician to personalize this plan.

TL;DR

Start with simple daily habits. If that isn’t enough, you and your clinician can consider an osmotic (like PEG) and add one option at a time. Use brief rescue measures only when needed. It’s reasonable to pause dose increases until you’re comfortable.

Why it happens

GLP-1s slow stomach emptying and reduce appetite, which lowers stool volume and water. Dehydration or sudden high-fiber changes can intensify symptoms during dose ramps.

A gentle, stepwise plan (to review with your clinician)

Step 0 — Daily base habits

• Fluids to pale-yellow urine; add electrolytes if you’re active or it’s hot

• Soluble-fiber foods when appetite allows (oats, chia, beans, kiwi)

• Easy movement most days (a 20–30 min walk counts)

• Unhurried bathroom time after breakfast or coffee; feet on a small stool

Step 1 — First option to discuss

• Polyethylene glycol (PEG 3350) once daily per label. Goal: 1–2 soft stools/day.

Step 2 — If comfort isn’t back yet

• Magnesium oxide at night per label (avoid with certain kidney or heart meds; ask first), or

• Docusate daily if stools are hard.
  These can be layered with PEG if your clinician agrees.

Step 3 — Short “rescue” only if needed

• Glycerin suppository once, or

• Senna or bisacodyl for 1–3 nights, then stop.
  If no change within 48–72 hours, message your clinic.

What’s usually not recommended without guidance

• Splitting weekly GLP-1 doses or trying to change pen volumes

• Big, sudden jumps in fiber gummies/bars

• Long-term daily stimulant laxatives

When it’s reasonable to pause dose escalation

• No bowel movement for 48–72 hours with discomfort

• Ongoing nausea or abdominal pain

• Upcoming anesthesia or a colonoscopy prep window

48-hour comfort example

Day 1: Keep base habits + PEG in the morning. If still uncomfortable by evening, many clinicians add magnesium at night.
Day 2: Continue PEG. If no BM by afternoon, a single glycerin suppository is often used. If crampy with little relief, one bedtime dose of senna or bisacodyl may be considered.
Day 3: If still no BM or pain increases, contact your clinician before adding more agents.

Food notes that help

• Lead with soluble fiber; introduce psyllium slowly with water

• Hold very high-fiber snack bars and large raw-crucifer servings until you’re regular

• Coffee helps some people; pair with a scheduled bathroom sit

Medication timing

GLP-1s delay gastric emptying. For narrow-therapeutic-index meds or oral contraceptives, ask your clinician about timing. Space fiber supplements away from other meds.

ScriptScores™: What to try first (0–10)

Higher = better for most GLP-1 users in everyday use.

Scoring method: editorial heuristic emphasizing comfort, adherence, and ease of use.

Red flags → contact your clinician now

• Severe or worsening abdominal pain, fever, vomiting, blood or black stools

• No bowel movement >3 days with pain or bloating

• New medications, kidney disease, or pregnancy

Disclaimers

• Not medical advice. General education only.

• Safety first. Seek urgent care for severe or worsening symptoms.

• Labels change. Follow current product labels and your clinician’s instructions.

• Individual results vary.

• ScriptScores™. Editorial heuristics, not treatment directives.
  Last updated: September 3, 2025.