Accepted answer
Week 10 is day 70: on a four-week ladder that is week 2 of dose step 3, and — at the seven-day half-life this class runs on — 10 half-lives in. Steady state is about five half-lives, so day 35 is where the concentration stops climbing on its own. Day 70 is 5 weeks past it, which means the level is no longer the variable. That distinction is most of the question: at week 2 of a step, an effect that is still accumulating is indistinguishable from one that is not resolving unless you know which side of day 35 you are on. Constipation is the one that does not follow the escalation curve. It builds with cumulative exposure and with the fall in food and fluid volume, so it characteristically appears later than nausea and outlasts it by months. Dose decisions are made under supervision, and nothing here is medical advice.
Start with the three inputs: fibre grams, fluid volume and physical activity. Most cases resolve on the first two.
Soluble fibre — psyllium, oats, legumes — holds water and softens stool. Insoluble fibre adds bulk and speeds transit. In slowed-transit constipation the soluble kind is generally the more useful of the two.
Gastrointestinal adverse events, indicative pooled rates
| Event | Active arm | Placebo arm | Timing |
|---|
| Nausea | 40–45 % | 15–20 % | Peaks 1–2 wk after each step |
| Vomiting | 15–25 % | 5–8 % | Follows nausea |
| Diarrhoea | 20–30 % | 10–15 % | Early, variable |
| Constipation | 20–25 % | 8–12 % | Later onset, persistent |
| Discontinuation for GI events | 4–7 % | 1–2 % | Mostly during escalation |
Ranges span agents and doses; read the specific prescribing information for a specific figure.
Mechanically, physical activity has a modest but real effect on transit time and is free, which makes it worth including even though it will not fix this on its own.
The fibre-and-fluid relationship in functional constipation is established across intervention studies, and fibre without adequate fluid worsens symptoms.
Nothing here is medical advice.
25 to 30 grams a day, deliberately planned, because it will not happen by accident.