Question: Hello, I am seeking advice on what to do next, for what I suspect is severe impaction.

I've been having constipation since last Wednesday (6 days) and have not passed since then. I normally pass 2-4 times per day. I am 30 yr old male and athletic. I do not recall having constipation at all in the past 5 years. I had been traveling on Wednesday and did not have the normal access to food, hydration, and toilet amenities -- also I was using a lot of diuretics (caffeine). By Thursday afternoon, I suspected blockage because I am very regular, had not passed since eating 6 large meals, had small amounts of very narrow stool and felt very very bloated (I eat 6 meals a day and lift weights). On Thursday, I skipped the gym because I felt bloated and took one dose of miralax. The next morning, I took a lot of metamucil and went on a liquid diet. By night, nothing happened except that I felt very weak. On Saturday, I tried 5 doses of miralax every 15 min for about an hour. Again, muddy water passed later in the day, but no solid stool. I began eating solid foods again, with lots of fiber and metamucil. On Sunday, I tried an enema -- again, muddy water but nothing solid. On Monday, I tried Milk of Magnesia (60mL). Two hours later, I tried Dulcolax (3 tablets). Again, just muddy water, no solids, and I continue to feel very bloated. Now it is Tuesday, and I'm afraid this problem is only going to get worse. I'm looking for extreme recommendations for what seems to be a worsening problem. Thank you.

I've been extremely well hydrated, active, taking lots of fiber and a lot of laxatives without any success for 6 days --- do you have any recommendations for taking laxatives together or in combinations for one last extreme try before going to the ER? Again, I'm as sure as I can be that it is a blockage by a stone hard mass of stool. For example, some folks (including the label) say to take Miralax 1 dose per day, and others (NIH for impaction) say take 7 doses spaced by 15 min. Should I take combinations of laxatives (stimulants, osmotic, softeners, suppositories) to try and make this work since nothing has so far? If so do you have any recommendations?