JustJ, I can so sympathize with your situation. Due to neurogenic bowel I normally have severe chronic constipation. I take antacids for GERD and they inhibit peristalsis. Then, my prescription opiate pain pills cause me to be really bound up.
My multiple docs have me taking one docusate sodium stool softener per meal, one cap of Miralax each day, and four Senna at dinner time. On top of that I take a high dose of Linzess specifically to counter the constipating effects of the opiates.
It works "fairly" well - most of the time. A down side of the Linzess is that it may cause some diarrhea. With the Linzess I will find stool in the rectum perhaps 40% of the time (I then do digistim to prompt defecation). I also may have loose stool/diarrhea about a third of the time, often causing an accident. However, without the Linzess I was fearful of an obstruction/impaction building up.
--John (double incontinent)
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