well any way i recently had bleeding from my bottom, went to the dr. he sent me to another dr. and then a colonoscopy.did the prep ,went to the proceedure,and after waking up ,they told me it was a poor prep ,5 days later ,a different prep and into sleep land and when i was woke up they said poor prep he could only get half way .and anyone in my shoes would think i was empty.but wasnt.at that point i was put on amitiza .it has cleaned me out good now i wait to see what they will do about the hemeroids.look they make fenagram for nausia , so if you have savere stopped up problems try the amitiza it does help....believe me when i say in one day i lost over 8 lbs. of weight not to say how much i lost the second day. with anyone on duragesic for a long time fiber is the enemy ...it does the opposite of normal .you will continue to clog if ya eat high fiber which most dr.s recomend...trust me sincerely mrs bailey