Dr.GastroMayo said:

I added fiber, made it noticeably worse, and only later worked out that I had added the bulk without adding the water.

Sulfur burps on constipation — the most underrated side effect nobody warned me about. 🤢 The smell is absolutely vile and comes on without warning.

What finally helped: Pepto Bismol before meals. Also, eating smaller portions and chewing thoroughly reduces the gas production.

If sulfur burps persist beyond 2-3 weeks, talk to your provider — it could indicate gastroparesis that needs medical attention.

One thing that is still open after PedsEndoPhilly’s answer:

What the mechanism is, because if it is transit rather than water then fiber is the wrong lever?

Dr.PathRoch said:

Sulfur burps on constipation — the most underrated side effect nobody warned me about.

Acid reflux and constipation: I developed GERD symptoms around week 4 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.

OP back with an update, since a thread like this is useless without one.

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

lisa_labSD said:

Acid reflux and constipation: I developed GERD symptoms around week 4 that I'd never had before.

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.