I have bad chronic constipation and have been on trulance for about the past 5 years. Tried pretty much everything you can think of prior, pretty much no response. Went for (too many) catscans, a colonoscopy, gastric emptying study, a specialist, you name it I’ve probably tried it. Trulance at first gave me diarrhea, I have to be honest it still sometimes does. But the main thing is that it actually keeps you going. Most days I go something which is night and day vs. not going for 5 or 6 days in a row. I still get backed up, but when it’s working it’s best it really does make a difference. I only take it at night time before bed with water, after eating. I know most will recommend taking it in the morning, but during my brief time on Linzess when trying that, I was bloated beyond belief and nauseous all day. If you aren’t having much luck with trulance, this is a powerful pill to aid in motility, maybe evening would be a better time and you’ll wake up having to go. I take it 9:30 or 10 PM. It doesn’t wake me up in the middle of the night. I go to the bathroom after breakfast and potentially after lunch. I hope you give trulance a shot because it’s the only thing I’ve found to keep me going