I am a physician, OB/GYN, retired------my girlfriend has what I assume is opioid induced constipation from a number of days of codeine containing cough syrup. We have tried a Fleets enema hours ago----no response. Magnesium citrate taken 3-4 hours ago, no response except increased cramping. This am about 7 hrs ago bowel sounds were somewhat hyperactive, now are present but attenuated. Abdomen is soft, non-tender in all 4 quadrants, no rebound. No nausea, moderate belching, passing some flatus off and on but no firm stool for 2 days. Normal colonoscopy 4 years ago. She has also taken stool softener but of course this won t act too quickly. Question: is another stimulant laxative now indicated----i.e., Miralax, or even one of the newer prostaglandin based agents, or is waiting longer for the mag citrate a better option now? She is leaving for New Zealand i 3 days and is concerned. Your thoughts?