I was born with Spina Bifida and often times the side effect is a neurogenic bowel so I have been dealing with constipation issues all my life. For the past 12 years I have been using enemas on a regular basis to maintain regularity and it has been a life saver. The medical community understands very little about motility issues and often time their advice is just dead wrong. It took a lot of experimenting with different solutions, time of day, ect. but I have found that a large volume enema with medical grade castile soap is the most effective for me.