If you don't have a regime that supports the medication, you could suffer some real problems. Drinking a LOT of water is mandatory. As well as eating lots of fiber - like good p-fruits (plum/pear/peach/etc) or benefiber/laxative.

I've had no problems following the advice of my weight loss program and r/Zepbound etc.

I've been taking the pill form of magnesium citrate and it helped SOO much im back to every day to every other day

For what it's worth, GLP-1s helped significantly with my IBS-D, and current research shows they're more effective and better tolerated than bile acid sequestrants.

YMMV

I’m totally with you. I’ve been lucky because a daily scoop of miralax has made me regular; unsolvable constipation would be absolutely miserable.

>fecal vomiting

omg... new fear registered...

Ultimately you get these extreme issues if you ignore a problem for too long. If you are becoming constipated and let it continue for many days on end without seeking some kind of treatment I feel that you are kinda to blame. I had some constipations at one point while on it and used some over the counter style fiber products and stool softeners to deal with the problem. If I ignored the problem of course I could potentially end up in these more extreme situations.

I think if people are choosing to use such medications they should make sure they are aware of the potential complications and are vigilant with their health to ensure these extreme side effects are avoided.