I have two things that work fairly well with me, but they sure won't work fore anyone!
The first one I discovered is eating a piece of fresh papaya with (before) every single (protein containing) meal. About 100 grams a day spread over the meals does the job for me.
It has good digestive enzymes that break down proteins. It is one of the few that start working from the moment they are in the gut. Most others are deactivated so that they would not damage the stomachs wall. I can't guarantee that these enzymes can't damage the stomach wall. But fresh papaya is eaten as a fruit in much larger quantities so it is relatively safe-ish *for most healthy people*. Other comparable enzymes are found in grapefruit, but these tend to interact more with conventional drugs. Either choice you make, consult on safety with your doctor first.
It gave me a good improvement in health within one to two weeks. I won't say it will improve constipation directly, but improved health in ME is a bonus to start with. And improved digestion is often good.
I have written on the topic in Healthrisings forum before this and I must admit no one reported similar good results as I had. But due to now writing these comments I may see what makes it work with me: I am one of the rare ME / gut dysbiosis patients that also has constipation problems. In the previous comment I wrote that one of the disadvantages of diarrhea to get food out of the body is that you risk to get more undigested proteins in your blood. So the body may turn to constipation to prevent that. Using this fruit helping with protein digestion starting already in the stomach would reduce the amount of undigested protein in the bowel. With it, it would reduce the need to resort to the mechanism of constipation rather then diarrhea for countering gut dysbiosis problems. That is, there would be less undigested proteins that can enter the bloodstream during a diarrhea reaction. Note this is an untested hypothesis!
By any chance, would "Doctor Myhill’s low-carb Paleo diet" be high in protein? There are two commonly used types of paleo diets: one with much protein and another type with limited protein only. Both have different advantageous and disadvantageous.
Another thing that helps me is psyllium husk. Yes, I know it made him worse and I respect Not Dead Yet! her experiences. But know that most psyllium husk sold contains more then that alone. Very often it has plenty of added fiber or pre-biotics. That is a clear no-no in my case! And pro-biotics are bad for me too. So check labels!
Also, my psyllium husk is packed in stomach acid resistant capsules. That makes it a lot more expensive. But psyllium husk is closely related to cellulose. Cellulose can irritate the stomach and cause mast cell degranulation. That is a common problem with ME patients and makes them worse. The tomach acid resistant capsules prevent that. They are more expensive, but taking 4 capsules (as indicated maximum on the label) with in total 1500 mg only a day does a fine job for me. That is much lower then the amount typically taken with the powder containing also pre-biotics. Sure it is no miracle cure but it helps slowly improve my gut. The effect of it is far more something building up over time then the quick papaya effect.
For people on a low-carb diet fresh papaya may contain a bit too much sugar. It contains some fructose too but for me the benefits outweigh the disadvantageous. You can also take papaine supplements, but for me the fresh fruit is superior.
Now how do I believe psyllium husk works? Psyllium husk is indigestible fiber. Many say the main difference between certain fibers is them being solvable or non-solvable. I place more importance on the difference between digestible versus indigestible fiber. The reason?
Bacteria tend to like to stick to surfaces. So I provide them surface area in the form of indigestible very fine grind (dust like) psyllium husk. The finer the grinding, the more surface area per gram. I like bad bacteria stick to psyllium husk a lot more then to stick to my gut wall and slip through it. There they can grow on the food they find and stay there. And then enjoy their ride on the way out without bothering my gut wall. That's why I believe *indigestible* to be important here. If the bacteria manage to eat all of the fiber they stick too, they'll have no surface left to stick too and release themselves and spread. I don't want that.
Other fine grind indigestible fiber may work just as well. I have no experience with it.
I also decide to take "advantage" of having constipation. Many doctors recommend high doses of oral vitamin C for ME patients. But oral dosing is limited as it tends to cause diarrhea by killing of gut bacteria. Therefore some doctors inject patients with vitamin C to get their patients high doses. It doesn't help much with constipation, but I have few problems with taking high doses of vitamin C
. And when drinking water with vitamin C before a meal, the stomach becomes more acid improving digestion. Many ME patients have too few stomach acid. Producing stomach acid costs energy. After the meal I drink less water. I already drank water before the meal to hydrate. And water after the meal dilutes stomach acid reducing digestion once more. I just drink enough after a meal to rinse my mouth and throat.
If you have any changes or experiences to share, please do.