When I first started flushing I found a site written by a Chiropractic service that stated that magnesium citrate should be used only when a patient could not tolerate the magnesium sulfate Epsom Salt). The citrate form of magnesium is an excellent laxative, but it is the sulfur compound that makes the biliary ducts relax. Sulfur is an important element in our diets and is believed to help keep skin and organs flexible and prevent hardening. Generally we take sulfur as a MSM supplement. There are also some excellent topical creams and lotions that contain MSM. It stands to reason that if sulfur can soften skin, promote the growth of collagen, and keep internal organs firm, yet flexible, then it must be the sulfate in Epsom Salts that help relax the biliary ducts.
There is a lot of posts affirming that sucessful flushes can be done without Epsom salt, but I am one person who would never attempt to flush without taken them, no matter how nasty they taste. I have passed solid (not clumped) stones measuring one inch by 3/4 inch. Without the ES I'm sure their exit would have been much more uncomfortable if possible at all.
In the same flush (my 8th, my 3rd flush with no epsoms), I passed 2 other stones ALMOST that size, plus about 250 stones the size of chickpeas.
BUT, I realize that you had many, many, health issues that I don't have Hopinso.
Magnesium citrate works just fine for me. I've done 3 different kinds of flushes, and I find that no epsoms with magnesium citrate upon waking works very well. Of course I do an enema and add extra fiber.
But overall, the magnesium citrate seems to work excellent. People with gallbladders and livers full of stones might feel comfortable using a little bit of epsoms (FSBoiera uses one tablespoon before he does the Julia Chang flush version). But he doesn't use anymore than that.
i did my lst flush last weekend with a good result... about 60 bb and pea sized stones... i too 1 tsp. of eps. about 8pm and then another tsp. about 10pm... then in the morning did the mag.citrate for the final push