Patient-Perspective Longitudinal Case Observation of Interactions Among Medication, Metabolic State, Bowel Motility, and Neuromuscular Symptoms

AbstractThis report presents a patient-perspective longitudinal case observation describing reproducible interactions among bowel-motility medication exposure, metabolic state, neuromuscular symptoms, diet, sleep, and mechanical factors in a physically active adult. Over approximately seven months, the patient systematically tracked medication use, bowel function, musculoskeletal symptoms, energy, sleep, food and beverage intake, and physical activity. Repeated observations suggested that plecanatide (Trulance) was associated with frequent watery bowel movements, pronounced fatigue, and increased spinal discomfort, while MiraLAX-supported bowel regulation was associated with greater stability. Rapid triglyceride changes were also observed in relation to diet and lipid-lowering therapy and appeared to coincide with changes in physical function and symptom burden. Across repeated observations, symptom severity appeared to vary according to bowel-motility medication exposure and triglyceride control, with the greatest impairment occurring during combined Trulance exposure and elevated triglyceride periods. During a later follow-up phase, discontinuation of coffee and reduction of hot beverages were associated with sustained improvement in bowel regularity, sitting tolerance, flexibility, breathing, and sleep. These observations are presented from a patient perspective to seek clinical insight rather than to establish causation. Files included in this record Main manuscript: PatientPerspectiveLongitudinalCaseObservationᵥ1. pdf Supporting clinical-detail file: PatientPerspectiveLongitudinalCaseObservationDetailedClinicalSupportingFileᵥ1. pdf