Dr.GutHealth said:

The mechanism is slowed transit plus reduced intake, and that combination determines which interventions work.

Acid reflux and constipation: I developed GERD symptoms around week 7 that I'd never had before. The delayed gastric emptying means food and acid sit in your stomach longer.

Management that works for me: elevate head of bed 6 inches, don't eat within 3 hours of lying down, avoid trigger foods (tomato, citrus, spicy, chocolate), and famotidine 20mg at bedtime. Much better now.

Following on from SarahChen_PharmD — and this may be the naive question:

Whether fiber actually helps GLP-1 constipation or whether the evidence is borrowed from a different population?

DoseLogDan said:

Acid reflux and constipation: I developed GERD symptoms around week 7 that I'd never had before.

Heartburn management on constipation: omeprazole 20mg has been my savior. The delayed gastric emptying means stomach acid just sits there.

Don't ignore persistent heartburn — chronic acid exposure can damage your esophagus. If OTC remedies aren't cutting it after 2 weeks, see your doctor for something stronger. You shouldn't suffer through this.

Reporting back.

Water and magnesium first, soluble fiber second, and dropping the bran entirely. Resolved in about a week after two months of getting it backwards.

claudia_zurich said:

Heartburn management on constipation: omeprazole 20mg has been my savior.

Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for hours after a small meal.

Tips: eat your protein FIRST (most important macro), then vegetables, then carbs last. Chew thoroughly — 20-30 chews per bite isn't excessive. Avoid carbonated beverages with meals. If symptoms are severe, your doctor may recommend a gastric emptying study.