# Struggles with Miralax



## dave9758 (Jan 10, 2017)

I have had issues with constipation my whole life. I am someone that had typically always had a bowel movement every 3 days. My stool throughout my life was usually lumpy and I almost always had to strain to have a bowel movement. Aside from having to strain every time I had a bowel movement, my constipation was manageable for most of my life. However, about 18 months ago, my constipation issues got much worse and I was not able to have a bowel movement without a laxative. I had a colonoscopy done last January and the only thing my GI found was that I had mild internal and external hemorrhoids. After the colonoscopy, I took Metamucil for a few months and it helped somewhat but it gave me tons of gas which interrupted my sleep and I couldn't pass my stool without having a cup of coffee.

Last March I began taking Miralax and it has been easier to have bowel movements since taking it but there have been a few very unpleasant symptoms that have been making my life miserable. The Miralax causes me to have a lot of gas (never had much gas throughout my life) and I can't seem to find the perfect dose. It either works too well and causes me to go to the bathroom too frequently or it doesn't work well enough if I cut my dose by a little but. Either way, the Miralax is causing me to get a poor night's sleep. I'm either getting up frequently to have a bowel movement or I'm laying in bed unable to sleep because I feel backed up. I want to note that prior to 18 months ago, I never felt backed up while I slept, even though I was only having a bowel movement every 3 days. Now I feel backed up if I go more than 1 day not having a bowel movement. If I do have a large bowel movement and feel cleared out, it is only a matter of a few hours before the Miralax starts kicking in and disrupting my sleep. The other issues I am having is that it is hard for me to have a bowel movement without a few ounces of coffee after waking up. This is an issue because I am very sensitive to caffeine and worsens the quality of my sleep. I can still fall asleep at night but when I consume caffeine during the day, I always wake up feeling less rested the next day. This is because the caffeine is interfering with my sleep stages and preventing me from getting a restful sleep. This combined with Miralax disrupting my sleep leaves me exhausted every day. I can't stay up more than 4 hours without having to take a 3-4 hour nap. I am unemployed and unable to work because of these issues. I am trying to get myself to a place where I would be able to hold down a full time job but it it proving to be really difficult.

I have done other things over the past 18 months to relieve my constipation like Metamucil, stool softeners, raisins, prune juice, increasing my water and fiber intake, but none of those things really did much to relieve my constipation. Miralax has been the only thing that has given me some relief but I am miserable being on it because of the side effects. I am concerned that Miralax could be killing my good gut bacteria and that it may not be good for my body. I know there are several different prescription pills you can take for constipation and wanted to know if you guys think these would be a better alternative to Miralax for me. For example, can they relieve my constipation without making me go to the bathroom so frequently? Would I have less gas while taking these pills?


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## annie7 (Aug 16, 2002)

Hi so sorry for all your problems. chronic constipation is miserable.

it sounds like you could have slow transit constipation (colonic inertia). a sitz marker test will diagnose this.

and yes, like you found, adding more fiber is not always the answer. fiber can help but only if one's constipation problems are caused by a lack of fiber to begin with. if your colon is already moving slowly, adding more fiber will just slow it down all the more.

miralax never helped me much at all, plus, like you, i had trouble with the side effects. have you tried milk of magnesia. we're all different but milk of mag worked better for me than miralax and the side effects weren't as bad.

there are also other magnesium based laxatives like MagOx, oxy powder, natural calm etc. those help some people. many people find that just taking a magnesium supplement, like magnesium oxide or magnesium citrate can help. you need to experiment to find the right amount to take. magnesium helps soften the stools which makes them easier to pass and it also helps relax the muscles in the colon to allow a smoother rhythm.

have you tried any stimulant laxatives like exlax or dulcolax? i had colonic inertia and after i tried everything and failed, my gastro doctors told me to take whatever i needed to go which for me was a stimulant laxative. my docs told me it was better to take a stimulant daily than to allow myself to get backed up and develop an impaction. you definitely want to get your gastro doc's approval before using stimulants on a regular basis.

about the constipation medications--everyone reacts differently to meds. they only way you are going to know how they affect you of course is to try them for yourself. linzess is available in two different dose strengths right now, with an even lower one in the pipeline--supposed to come out later this year. there are also various ways of tweaking linzess to get it to work better for you. amitiza is also available.

we have lots of information here on the board for dealing with chronic constipation so you might want to take a look around and do some reading. here is one thread:

http://www.ibsgroup.org/forums/topic/152106-the-great-list-of-remedies/

good luck with everything. hope you can find some relief. take care.


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## flossy (Dec 8, 2012)

Hello dave9758,

I've used Miralax on and off, it is okay, but that's about it. It's very popular though.

I highly recommend you try this instead (click on below link to read):

http://www.ibsgroup.org/forums/topic/239065-finally-a-product-i-can-recommend/

I've been taking 2 or 3 Intestinal Formula # 1's and one Intestinal Formula # 1 maximum strength every day (while eating) for well over a year now, haven't tried anything better.

Good luck and keep us posted!


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## Displaced (Feb 14, 2007)

Dave, I wish I could offer you some help, but my situation is in ways similar to yours. I've tried a couple of the prescription meds for IBS but they quickly lost effectiveness, so my GI doctor has nothing much to offer but continually advising me to use Miralax regularly instead of just off and on. I've used it occasionally for years and often generated bowel activity from a very low dose, while now, after about 6 months of almost-daily use, I don't think that even a tablespoon per day is really helping; I know that isn't the full, recommended dose on the label. I seem to be in a pattern awfully similar to when I wasn't using anything: several days without activity, followed by one or more nights when I have trouble sleeping (not necessarily because of pain or cramps, just an awareness that "something" is going on), and then a day when I can have 6 or 8 bowel movements, usually starting right after breakfast and lasting until mid-afternoon, occasionally later. I then skip a day, maybe two, or the Miralax on the theory that I'm all cleaned out, but soon find myself uncomfortable again. I don't know whether I should be taking more, for example if that would generate more regular activity instead of the extremes, or whether taking a higher dose would just cause a lot more of the horrible high-frequency days.

Although I've been told that you can't develop tolerance to Miralax, I feel like I have; maybe it's psychological, not physiological, since I don't know what else to do if keep escalating the dose and reach a point where it doesn't help at all. I work at home, which is an advantage when I have those awful days, but I do worry about how my IBS or chronic constipation may affect me when I have to be away from home or out of town. I'm reluctant to see the doctor again because I don't think he has anything new to suggest. It's a difficult situation we're in, and I sympathize with you. I hope that some of the other suggestions will help you.


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## dave9758 (Jan 10, 2017)

Displaced, sorry to hear you are dealing with a similar situation. Your body can definitely develop some tolerance for Miralax. When I started taking it one year ago at the regular dose, it made me have bowel movements all day. Now, that same dose will only produce 1-2 bowel movements a day and it definitely does not clear me out. I have had to gradually increase my Miralax dose to have complete evacuation. What is interesting is that I originally thought Miralax was causing my gas but my GI doctor said that Miralax doesn't actually cause gas, it is the bacteria in the gut that is creating the gas as it is digesting our food. I barely ever had gas before I started taking Miralax. This right there tells me that my gut flora has changed. This may not necessarily be directly due to taking Miralax but when my constipation got much worse 18 months ago, I took a number of laxatives, including Miralax, that completely cleared me out. When I say cleared me out, I mean having diarrhea for 24 hours straight. I'm guessing that this flushed out some of my healthy gut flora and that is why I am having so much gas. I have been starting to take the probiotic Culturelle to replenish my healthy gut flora but it is too soon to tell if it is working. Aside from that, my GI doctor told me to take Gas-X which I have not yet started taking but hopefully it will help.

Ultimately, I don't think the long term answer to our constipation problems is taking medication. I believe that for most people there is some sort of natural solution that can work for them. At least in the U.S., I believe that the crap American diet has jacked up our bodies and digestive systems and for us, we must change our lifestyles to eat healthier. I recommend seeing some sort of natural medicine practitioner such as a Naturopath or a Chinese Medicine practitioner. I would have already done this but can't because I have no money to do so but as soon as I start working again, this is what I will be doing. Not only that but I plan on eliminating junk from my diet and experimenting with different diets such as a whole foods plant based diet and a Paleo diet.


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## jza (Oct 4, 2016)

I've had to increase my Miralax dosage as well since I first started on it. I won't take more than 3 caps per day. I usually go at least once a day now, but it's never complete evacuation.


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## PD85 (Aug 19, 2010)

I would definitely switch from Miralax to magnesium citrate if I were in your shoes.


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## jza (Oct 4, 2016)

I used to have luck with 1.5 caps. Now I can take 4 and it won't even necessarily make me go. Very frustrating.


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## jza (Oct 4, 2016)

jza said:


> I used to have luck with 1.5 caps. Now I can take 4 and it won't even necessarily make me go. Very frustrating.


I switched to milk of magnesia, and it's helping a lot. I don't take it every day either. I'm hoping the MoM doesn't lose it's effectiveness too.


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