I've had lifelong constipation and was only offered effective treatment a few years ago, by a gastroenterologist who pointed out that it should have been offered to me from the start.
I have tried virtually every remedy there is. My "slow colonic transit" was confirmed by tests the gastro ordered. Objective proof.
The treatment was to use Fleet enemas in a systematic way over some weeks to give my poor colon a rest so it could try to work normally. I was also prescribed the generic version of Metamucil, and a medication called Laxsol, that is made of Senna and Ducosate. Laxsol was the key for me.
What a difference it made to my quality of life to not have the severe abdominal and other pain from this condition. GPs should inform people with chronic constipation of the risks they face from permanent changes to the size of the descending colon, to the functioning of the anorectal area itself, haemorrhoids, fissures, and even potentially, cancer. Constipation can also lead to bladder dysfunction and incontinence, and back pain/pinched nerves.
If you find the less drastic remedies work for you, that is great. But if you are not making headway after trying them, you might want to chat about it with your GP. Treatments like Fleet, Metamucil and Laxsol, used in the right way, can prevent a lot of problems that in my experience are worse than constipation.