What gastrointestinal (GI) supplement can I take for gentle and quick relief of constipation and straining while taking Adderall (amphetamine and dextroamphetamine)?

Managing Constipation While Taking Adderall

For gentle and quick relief of constipation while taking Adderall, polyethylene glycol (PEG) is the most effective option, as it provides reliable relief without worsening your symptoms. 1

Understanding Your Symptoms

Your symptoms of distended stomach, straining during bowel movements, and feeling backed up are consistent with constipation, which is a known side effect of stimulant medications like Adderall (amphetamine and dextroamphetamine). Stimulants can slow gut motility and reduce intestinal secretions, leading to harder stools and difficulty passing them.

First-Line Treatment Options

Osmotic Laxatives

• Polyethylene glycol (PEG): This is the strongest recommendation based on current guidelines
  • Available over-the-counter as MiraLAX
  • Works by drawing water into the intestines to soften stool
  • Take 17g (typically one capful) mixed in 8 ounces of water once daily
  • Shows durable response over 6 months with minimal side effects 1
  • Provides significant increase in bowel movements compared to placebo

Fiber Supplements

• Psyllium (Metamucil): Can be considered as a first-line option, especially if your diet is low in fiber
  • Take with at least 8 ounces of water per dose
  • Start with a low dose (1 teaspoon) and gradually increase as needed
  • Has been shown to increase stool frequency and improve stool consistency 2
  • Superior to docusate sodium (stool softener) for increasing stool water content 3

Important Cautions

1. Adequate hydration is crucial:

   • Always take fiber supplements with plenty of water (8-10 oz minimum)
   • Insufficient fluid intake with psyllium can actually worsen constipation or even cause intestinal obstruction 4

2. Avoid certain supplements:

   • Docusate sodium (stool softener) has not shown benefit and is not recommended 1
   • Supplemental medicinal fiber like psyllium may worsen constipation in some cases if not taken with adequate fluid 1

Implementation Plan

1. Start with PEG (MiraLAX):

   • Take 17g (one capful) mixed in 8 ounces of water once daily
   • Continue for several days until bowel movements normalize
   • Can be used safely for longer periods if needed

2. If PEG is not available or preferred:

   • Try psyllium (Metamucil) - start with 5g twice daily with at least 8 ounces of water per dose
   • Ensure you're drinking plenty of fluids throughout the day
   • Monitor for improvement in symptoms

3. If symptoms persist:

   • Consider adding a stimulant laxative like bisacodyl or senna for short-term use
   • Magnesium-based products can also be helpful as an alternative 1

Lifestyle Modifications

• Increase overall fluid intake throughout the day
• Maintain adequate dietary fiber intake from fruits, vegetables, and whole grains
• Exercise regularly if feasible, as this can help stimulate bowel function
• Consider taking your Adderall with food to potentially reduce GI side effects

Remember that constipation from stimulant medications like Adderall often requires ongoing management rather than a one-time solution. The goal is to achieve one non-forced bowel movement every 1-2 days 1.