Chronic constipation. Others no use!

Chronic constipation for more than 2 years that has not improved despite medications such as Lintide (linaclotide), Prucalopride (Purivict), Pegfiber and other laxatives requires a detailed evaluation rather than simply adding more medicines. I would recommend: 1. Consult a Surgeon for further workup. 2. Basic investigations:     * CBC, Thyroid profile (TSH)     * Blood sugar, calcium levels 3. If not already done, consider a colonoscopy, especially if there is:     * Blood in stools     * Weight loss     * Family history of colorectal cancer     * Change in bowel habits 4. In refractory cases, specialized tests may be needed:     * Colonic transit study     * Anorectal manometry     * Defecography (if outlet obstruction is suspected) A few questions that would help: * How many times do you pass stools per week? * Do you have to strain excessively? * Is there a feeling of incomplete evacuation? * Any bleeding, weight loss, abdominal pain, or bloating? * Have you undergone a colonoscopy before? Meanwhile: * Drink 2.5–3 liters of water daily. * Aim for 25–35 g of dietary fiber per day. * Regular exercise and a fixed toilet routine after meals may help. * Avoid frequent use of stimulant laxatives without medical supervision. Since you are only 32 years old, cancer is less likely, but constipation that persists despite multiple medications should be investigated to identify the underlying cause rather than continuing trial-and-error treatment.