GI Specialist Reveals the “Upstream Blockage” That’s Paralyzing 73% of Ozempic Patients (And Why Miralax Can’t Reach It)
New research explains why laxatives fail for GLP-1 users—and what actually works
If you’ve been on Ozempic, Wegovy, Mounjaro, or Zepbound for more than a few weeks, you probably know the feeling.
That “brick” sitting in your stomach. The sulfur burps that taste like something died inside you. Days—sometimes over a week—without a bowel movement despite taking Miralax twice a day.
You’ve tried everything. Dulcolax. MagO7. Fiber gummies. Prune juice. You’ve Googled “Ozempic constipation” at 2 AM more times than you’d like to admit.
Nothing works. Or worse—it works once, violently, then you’re right back to being stuck.
Here’s why: You’ve been treating the wrong end of the problem.
The “Upstream Blockage” Your Doctor Isn’t Talking About
Dr. Maria Santos, a gastroenterologist who’s treated over 1,500 GLP-1 patients in the past two years, recently published findings that explain why traditional constipation remedies fail for this population.
“When a regular patient comes in with constipation, I tell them to take Miralax. It works,” Dr. Santos explains. “But when a GLP-1 patient comes in with constipation, Miralax often does nothing. They’ll take it for a week straight and not go. That’s when I know we’re dealing with something different.”
The difference? Location.
Miralax, Dulcolax, fiber supplements, stool softeners—they all work on the colon. That’s the last six feet of your digestive tract. The exit.
But GLP-1 medications don’t cause problems in your colon. They cause problems in your stomach.
“Semaglutide and tirzepatide work by slowing gastric emptying,” Dr. Santos says. “That’s the whole point—your stomach holds food longer, so you feel full and eat less. But in a significant percentage of patients, the stomach doesn’t just slow down. It practically stops.”
She calls this the “upstream blockage.” Food enters the stomach and just... sits there. For 12, 18, sometimes 24+ hours.
“You can take all the Miralax in the world,” she says. “But if food isn’t leaving your stomach, there’s nothing for the Miralax to work on downstream. You’re trying to unclog a drain when the water is shut off at the source.”
Why Food “Rots” Inside You
That sulfur burp you’re desperately trying to hide from your husband? It’s not in your head.
When food sits in your stomach for that long, it ferments. The same way leftovers go bad if you leave them on the counter overnight.
“Hydrogen sulfide gas is a byproduct of that fermentation,” Dr. Santos explains. “That’s the rotten egg smell. Patients describe tasting Tuesday’s dinner on Thursday morning. They’re not exaggerating—that food has literally been decomposing inside them for 48 hours.”
The nausea. The bloating. The feeling like your stomach is a “concrete mixer.” It all traces back to the same upstream problem: the stomach muscles have essentially fallen asleep.
“It’s not constipation in the traditional sense,” Dr. Santos says. “It’s gastroparesis—partial stomach paralysis. And you can’t fix a paralyzed stomach by forcing open the exit door.”
The Laxative Trap
Most GLP-1 patients fall into what Dr. Santos calls “the laxative trap.”
They take Miralax. Nothing happens. So they take more. Still nothing. They add Dulcolax. Maybe some Mag07. They drink a whole bottle of magnesium citrate over a weekend.
Then one of two things happens:
Scenario A: Still nothing.
The upstream blockage is so severe that even aggressive laxatives can’t force things through. The patient is now bloated, cramping, AND still constipated.
Scenario B: Everything comes out at once.
Violently. Unpredictably. The patient is afraid to leave the house for two days. Then, within a week, they’re right back to being stuck.
“Neither scenario is healthy,” Dr. Santos says. “And neither addresses the root cause. You’re not treating the problem—you’re just periodically forcing the exit door open while the entrance stays blocked.”
She sees patients who’ve spent hundreds of dollars cycling through every OTC remedy at CVS. Women who’ve had to cancel vacations because they couldn’t trust their own bodies. Who’ve considered quitting the medication entirely—even though it’s the only thing that’s ever worked for their weight.
“That’s the cruel irony,” she says. “They finally found something that silences the food noise. That actually helps them lose weight after decades of failed diets. And now they’re thinking about stopping because they can’t go to the bathroom.”
The Three Problems Happening at Once
Dr. Santos’s research identified that GLP-1 patients aren’t dealing with one problem. They’re dealing with three—all at the same time:
The stomach stops moving.
GLP-1 medications slow gastric emptying—that’s the whole point. But in many patients, the stomach doesn’t just slow down. It practically stops. Food sits for 12, 18, sometimes 24+ hours. The muscles that normally churn and push food forward are essentially asleep.
The trapped food ferments.
When food sits too long, bacteria break it down and produce hydrogen sulfide gas—the same compound that makes rotten eggs smell. That’s the sulfur burps. That’s the “tasting Tuesday’s dinner on Thursday” phenomenon. It’s not in your head. Your food is literally decomposing.
Everything downstream dries out.
By the time anything reaches the colon, it’s been sitting so long that all the moisture has been absorbed. It’s hard. It’s dry. It’s concrete. And that’s what creates the days-without-going constipation that no amount of Miralax seems to fix.
“All three problems feed each other,” Dr. Santos says. “The stomach doesn’t move, so food ferments, so gas builds up, so motility gets even worse, so things downstream get harder and drier. It’s a vicious cycle. And laxatives only touch problem three.”
Why “Just Juice Celery” Doesn’t Work
If you’re on GLP-1 TikTok, you’ve seen the celery juice posts. And the science behind celery isn’t wrong—apigenin, a compound found in high concentrations in celery, does support gastric motility. It’s a prokinetic. It helps wake up the stomach muscles.
But here’s the problem:
“When your stomach can’t empty, the last thing you want is 16 ounces of liquid sitting on top of what’s already stuck,” Dr. Santos says. “Most of my patients who tried celery juicing threw it back up or quit within a week. The volume is torture on a paralyzed stomach.”
Same problem with fiber supplements. Even the “gentle” ones add bulk that a slow stomach can’t handle. You’re piling more weight on top of a traffic jam.
And chlorophyll drops? They can help with the sulfur gas, but they don’t address motility or downstream hydration. You’re treating one problem out of three.
“What these patients need is all three mechanisms in one low-volume format,” Dr. Santos says. “Something that wakes up the stomach, neutralizes the gas, and softens what’s downstream—without making them drink or chew a bunch of stuff that’s just going to sit there.”
A New Approach for GLP-1 Patients
This need has created a new category of products designed specifically for GLP-1 patients—what some are calling “GLP-1 companions.”
One product gaining traction among Dr. Santos’s patients is called Motilli. It’s a celery juice gummy that combines all three mechanisms: the prokinetic compounds from celery to support motility, chlorophyll for gas neutralization, and FOS prebiotic fiber for downstream hydration.
“Three gummies,” Dr. Santos says. “No juicing. No 16-ounce glasses of anything. No horse pills.”
“It’s pectin-based, not gelatin,” she notes. “Pectin dissolves easily—important when your stomach is slow. Gelatin can sit there like a gummy bear in a glass of water.”
It also includes vitamins A, C, K, B6, and Folate—nutrients her GLP-1 patients are often deficient in because they’re eating so little.
“B6 in particular helps with nausea,” she says. “And the A and C support skin elasticity, which matters when you’re losing weight quickly.”
What Patients Report
Dr. Santos started recommending Motilli to her most severe cases about six months ago. The pattern she sees:
Days 1-3
The “brick” feeling starts to lift. Food doesn’t sit as long. Some patients notice fewer sulfur burps almost immediately.
Week 1-2
Regular bowel movements return. Not urgently, not explosively—just normally. The cycle of constipation-then-disaster breaks.
Month 1+
Most patients report throwing out the Miralax and Dulcolax they’d been cycling through. The medicine cabinet clears out.
“It’s not a cure for gastroparesis,” Dr. Santos is careful to note. “The medication will always slow things down—that’s how it works. But for most patients, this makes the difference between ‘I can’t live like this’ and ‘I can actually manage this.’”
The Question to Ask Yourself
If you’ve been on a GLP-1 for more than a month and you’re still fighting constipation despite a cabinet full of laxatives...
If you’ve tried Miralax, Dulcolax, fiber, and magnesium and nothing works—or it works once then stops...
If you’re considering quitting the medication because the side effects feel unbearable...
The question isn’t “what other laxative should I try?”
The question is: “Am I treating my colon when the problem is in my stomach?”
Downstream solutions can’t fix an upstream blockage.
Your stomach isn’t broken. It’s just asleep. And there’s a way to wake it up—gently, without the cramping and unpredictability of traditional laxatives.
Ask your doctor about prokinetic support. Look into products designed specifically for GLP-1 patients. And stop spending money on remedies that were never designed for what you’re dealing with.
The upstream problem needs an upstream solution.
Wake Up Your Stomach. Break the Laxative Trap.
Three pathways. One gummy. No more Miralax cycling, no more unpredictable disasters, no more choosing between weight loss and digestive relief.
Motility. Deodorization. Hydration.
Three gummies. No mess. Just done.
Motilli is a dietary supplement. It is not intended to diagnose, treat, cure, or prevent any disease. Consult your doctor before starting any new supplement, especially if you are on GLP-1 medications.