I've had severe constipation since going on APs. I've been on a prescription med called Amitiza for many years and mostly it keeps things fairly regular to very regular. Since having my gallbladder removed in February things have been unbalanced and we're working on that but in general it really helps. Sometimes I've needed ducosate and/or senna or miralax and occasionally it gets so bad I have to do magnesium citrate (bowel prep basically) which is highly unpleasant but mostly Amitiza helps.