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When to call your provider Within 3-5 days: No bowel movement for 5+ days despite using Miralax or other osmotic laxative Severe abdominal pain or distension Inability to pass gas Vomiting, especially if it tastes or smells fecal Within 1-2 weeks: Constipation not improving after 2 weeks of consistent dietary changes plus Miralax Blood in stool (bright red or dark/tarry) Severe pain during bowel movements Unintended weight loss beyond expected from the medication At your next scheduled visit: Mild persistent constipation that's manageable but bothersome Questions about whether to escalate dose given current constipation Interest in prescription motility agents The threshold for calling is lower if you have a history of bowel obstruction, diverticulitis, inflammatory bowel disease, or prior abdominal surgery

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Serious side effects range from pancreatitis and kidney disease to low blood sugar and vision changes

Subsequently, the BPI product received final FDA approval. The company also noted that neither Belcher nor BPI have ever had Warning Letters issued to them from the FDA

The Challenge Detecting neutralizing antibodies posed several unique challenges