After months of avoiding Trulance because I was afraid it would cause diarrhea, I've been on it for several weeks. Surprise, surprise. Not only don't I have diarrhea, but its effect is limited. While my GI doctor assumed, or hoped, that it would result in regular bowel movements, preferably every day, I'm lucky to have something every two or three days. I also think it takes away my appetite and may be causing weight gain (those two things seem contradictory, but if the drug is causing weight gain, it has nothing to do with how much I eat). On top of that, the stools are sometimes bulky and difficult to pass, aggravating the hemorrhoids that are already a problem. While I'm waiting for a follow-up office visit in about two weeks, I've been exchanging emails with the doctor's office. They are now suggesting that I take Miralax, several times a day if necessary, as well as a fiber supplement. Well, if I need MIralax, which is what I've always fallen back on when prescriptions failed, why should I bother with Trulance? While taking Miralax wasn't a perfect solution, it may be better than this strange prescription, and a lot less expensive. I think my experiment is about done. At least I can say I tried it, and the doctor can stop nagging me.