Brief Answer:
Investigation and bowel training.

Detailed Answer:
Hi.
Thanks for your query.
It is good that you already had a consultation with a Gastroenterologist. Have undergone colonoscopy. ( I take this as normal as you have mentioned -'' but to no avail''.
Your history of problem and medicines noted. You have tried fleet enemas and miralax metamusil and diet change.

First of all I would like to know whether you are taking anything which also can cause constipation, like any medicines or such substances which are known to give constipation in your case.
Are you suffering from diabetes?
All these cause a condition called gastroparesis, meaning slowing of the movement of food along the intestinal tract.

I would advise you to undergo an investigation called Enteroclysis. In this the passage of the barium in monitored on a machine called fluroscopy. This gives the best information about the time taken for barium to pass through various parts of intestinal tract, show many conditions like stricture, obstruction, diverticuli and so on.

I would also advise to take a help of bowel trainer, the paramedics who help the people to have normal bowel movement after surgery on intestines, in cases of colostomy/ enterostomy. They can teach you about normalizing the body clock to have normal urge and solving your problem.

Your history says at one point that you have constipation and then on other days diarrhea. No urge to go- you get the urge once a week. and pass a couple of hard pellet. >> this indicates you need to ad natural probiotic like curd to your diet and take probiotic capsules. ( the mass of the stool has a very large content of bacteria which forms a large part of the stool).

Bloating is obviously die to constipation, it will resolve on its own once the problem of constipation is resolved. Appetite will automatically improve.

You have to change your eating habits of having meal once a day. You have to start taking breakfast, lunch, brunch and dinner off all the foods.

This is very true the bowel habits- the urge is as per the bowel training and body clock one sets and is different of each person. Try taking something in the morning like warm water, tea which may stimulate the urge.

Try taking enema and / passing glycerin suppository ( to be passed into the rectum) daily morning and preparations containing paraffin and sodium picosulphate in the night. The dosage will depend upon your requirements ( requirement is different in all the people). Stop everything of the foods, habits, that you must have observed to increase the constipation.
This will help in training the bowel and have the urge to pass stool.Further treatment will depend upon the findings on investigation

---