Miralax 4 x daily & lactulose 60 ml daily. constipation worsening. abdominal x ray revealed distended colon. ct scan normal other than air fluid??

Chronic constipation: Given your results, you should see a gastroenterologist. You may be able to see someone more readily via HealthTap.

Worrisome/ fixable: You should seek out a gastroenterologist with experience in bowel rehab. The large intestines will balloon after months/years of stool retention & this weakens emptying. Reversing the process requires a colon clean out & regular scheduled emptying using a variety of methods.It can take a year or more to rehab your system but it is doable. Short term cleanout without follow up work is wasted effort