Hi. Thanks for your query. Noted the history about a 44 year old with Graves disease, Myasthenia gravis and tachycardia, swelling in stomach as if 9 months pregnancy, was told to be due to hiatus hernia, choking on swallowing, constipation and taking Dulcolax twice a week, got a reference to GI Doctor and wants whether Dulcolax can be taken more times, and for how much time period. As per the history you have provided, the basic problem is Graves disease that is severe Hyperthyroidism. This causes Tachycardia. Myasthenia in itself is a different problem. I would advise you the following: First of all get your thyroid into proper control with Beta blockers and Neomercazole, most of the problems will get under control including tachycardia. The bloating of stomach can be returned to normal. Grave s Disease actually gives diarrhea and not constipation hence the cause can be impacted fecoliths in large bowel. Get an X-ray of the abdomen in standing position to know about dilated bowel loos, fecoliths and if present get a saline and soap enema and you can certainly take Dulcolax one to two every night till bloating goes away and then reduce to one at night and then alternate nights so that you do not get addicted to laxatives. hiatus hernia is strictly a diagnosis by Upper GI Endoscopy and small hernia does not need any surgery unless the symptoms do not improve on medications, diet control and weight management.