# How much is too much miralax when severely backed up?



## Blue2 (Mar 9, 2017)

Hey everybody,found this forum last night and have been so happy to have stumbled upon this great resource!

A brief history, I'm a woman in my mind twenties and was diagnosed with IBS-C at around 14 years old. So it's been a bit over a decade now. The long and short of it has been, various doctors, blood tests, xrays, ultrasounds, and several CT scans have found a few things. One- that I have several medium sized "functional" ovarian cysts. Opted to not have them removed as the doctors didn't seem to find it necessary unless I was in pain (as an aside, any way this could be relating to my constipation woes?). In an ultrasound meant to see any issues with a recent flare up and abdominal pain I was having it was found my gallbladder was ready to rupture. My surgeon told me it was the worst she'd ever seen and I was very lucky to have had the ultrasound when I did. I was also told that the gallbladder removal had a good chance of relieving my IBS symptoms....it did not though. Finally, I've been told that I have very low colonic motility.

Currently: I've been taking miralax twice a day now for awhile and it has been the most effective medicine I've found so far. Linzess worked for about a year, but then stopped. Amitiza never worked and gave me horrible side effects. Anyways, these past few months I've been relatively asymptomatic. Stupidly I thought it wasn't a priority to keep on the miralax when I last ran out. Well that was two weeks ago and the only bm I've had since then has been mucus. I never really even noticed until I was doubled over in pain quite suddenly two days ago and I realized that I haven't used the bathroom in quite a while. I've only been able to pass mucus since then, in part because everything is so dry I think. The pain has not let up in the past two days, and I wasn't able to lie down to sleep last night. I got some miralax yesterday however, and I've taken 3 capfulls since yesterday afternoon. Afternoon, night, and early morning. I know it'll probably take a few days to kick in and that's what's stressing me out.

My question(s): Anything I can take for fast relief? Also how much is too much miralax? I've read that to cleanse out their system some people take a dose every hour until they have a bm...is this safe to do? Or would going back to my twice daily doses, and just waiting it out until it kicks in, be smarter?

Thanks for any input, much appreciated!


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## annie7 (Aug 16, 2002)

have you not had any kind of bm whatsoever for the last two weeks? have you been able to pass any gas?

i'm concerned that you may have developed an impaction or even worse, an obstruction.

an impaction is when you go for a while, like a week or so, with no bm at and then all of a sudden you get watery diarrhea which is the body doing a sort of "self enema" by using the watery D to unblock things....

symptoms of an impaction include abdominal cramping and bloating, leakage of liquid or sudden episodes of watery D, small, semi formed stools, rectal bleeding, low back pain...

if you totally stop passing any kind of stool at all and stop passing gas, then you may have develop an obstruction. symptoms of obstruction also can include nausea and vomiting and fever. this is an ER situation

an obstruction means the stool cannot move, has completely filled that part of the colon, nothing can get by, not even gas and eventually you will begin to vomit up stool when it needs to get out but it can't due to the obstruction. i've had one, so believe me , i know. not fun.

the best thing to do is to call your doc for advice. whenever i got this way, my gastro would order an x ray. his advice on how to clean out would be based on just what the x ray showed.

sometimes i would be told to do a large volume enema (not a fleets--too small). mineral oil enemas are good at softening up hard, backed up stool. other times, he would tell me to do half a colonoscopy prep to clean out. that involves mixing up and drinking a bottle of miralax. i would always have to add a stimulant laxative--dulcolax--to move it all out. i had colonic inertia, pelvic floor dysfunction and some other problems and miralax alone never worked for me. if you do drink lots of miralax like this, be sure and drink some gatorade or pedialyte with it to help keep your electrolytes up.

some people drink a bottle of magnesium citrate to clean out.

but like i said, your doc's advice is always the best. good luck with everything. hope you get some relief soon. take care.


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## Blue2 (Mar 9, 2017)

Oh yikes, I'm sorry that happened to you , obstructions definitely don't sound fun. I guess that would be my worst fear. I have been able to pass gas, although at times it can be difficult. I also have had a couple of very small inconsequential bm's. Just so small that no relief was had really. What my "normal" has been is I'll usually go like a week without a bm, and several emptying and complete ones within a day. The pain is particularly bad at the moment though.

Thanks for the tips though, gatorade is a smart idea! I'm hoping I can get some relief today, but I will be making a doctors appointment. I just get stressed when getting to that point, like I assume the worst and start panicking. I know practically that does no good, frustrating though.

Again, thanks so much for taking the time to respond!


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## annie7 (Aug 16, 2002)

yes, i do hope you get some relief today--you really need to get things going ASAP before it becomes worse.

if you want cleanout advice from your doctor, hopefully you can just call the office and ask--either leave a message for the doc or talk to a nurse. that way you can get an answer sooner than by making an appointment. if they insist you must have an appointment, i do hope that you can be seen today.

so even with miralax twice daily, you only have a BM once a week--that's your "normal"? that really doesn't sound too normal or good for you. it's hard on your body to have all that stool in there for so long. you might want to talk to your doc about this and see he/she can come up with a treatment plan that will get you going more frequently than that. the longer stool stays in there, the more dried up it becomes and the harder it is to get out. because i had a tendency to develop impactions rather easily, my gastro docs told me to take whatever i needed to go on a daily basis.

so sorry about the pain. maybe a heating pad will help. hopefully you'll get going soon. that will relieve the pain.


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## flossy (Dec 8, 2012)

Blue2 - Hi. You should probably have a BM once a day. This has worked well for me, been on it almost two years now (click on below link to read):

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


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## Blue2 (Mar 9, 2017)

Thanks to the both of you for giving me such good advice. Maybe I've been naive but I had thought that since there was relatively no discomfort and the bm's were easy to pass, that the length in between wasn't much of a concern. However when I have flare ups such as these, it's no joke. I have an appointment for tomorrow morning and I will bring that issue up. Fingers crossed it all goes well.


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## annie7 (Aug 16, 2002)

glad you were able to get an appointment today--good luck. keep us posted.


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## Blue2 (Mar 9, 2017)

So for an update: after an xray and ultrasound it was determined I was indeed severely backed up. I've had several emergency related abdominal surgeries over the past few years, and they were worried because they said the built up scar tissue looked like it was twisting my colon to an unnatural position. This happened once last year, I got lucky this time though and after a second opinion was free to go with an enema to take home. I was told to go to the e.r. if the enema did not produce a substantial bm.

With all my chronic constipation woes over the years I've never done an enema, honestly I'd been too afraid. But doctor told me laxatives would be insufficient at this point. I was given a fleet mineral oil one and had some problems actually squeezing the liquid out. I used the whole bottle and held it for 15 minutes. Doctor led me to believe this would be difficult to do so I'm worried that this is a bad sign that I never really got an "urge" but the box said to not hold for more than 15 minutes. I did have a very substantial bm, despite some pain and straining still. I feel relief (and sorry if this is tmi) and got everything in my rectum out....but I only feel about 50% cleared out. Feels like it's higher up. Anyways is this normal for an enema in this situation? Will laxatives be more effective for the rest of it now? Thanks


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## flossy (Dec 8, 2012)

This pretty much covers everything I've learned over the years in regards to chronic constipation:

http://www.ibsgroup.org/forums/topic/325690-the-abcs-of-chronic-constipation-aka-ibs-c/

P.S. If you have any questions or comments, please feel free to post 'em.


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## annie7 (Aug 16, 2002)

thanks for the update. i was wondering how things were going.

so sorry you have abdominal adhesions from your previous surgeries. i've had several abdominal surgeries and have adhesions as well--they are nasty. and yes they can twist and block the bowel. i've had two emergency lysis of adhesions surgeries in the past 18 months because of that happening. and, now of course, the adhesions have grown back.

anyway--glad the fleets got some out but you're right--they are small enemas and don't reach higher up. when i had my obstruction, i used two large size fleets mineral oil enemas, followed by a large volume enema (the big red bag) and then a combo of stimulant and osmotic laxatives. and all that finally cleaned me out.

yes, you could try laxatives--a combination of miralax and a stimulant laxative would be the most effective. or you could go to the ER --or urgent care--like your doctor said if you feel that's necessary. good luck.


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## Blue2 (Mar 9, 2017)

Awesome post! I could relate to so much of what you said. I think I've tried to ignore it or tough it out for too long. It's nice to read what's worked and what hasn't for other people.


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## Blue2 (Mar 9, 2017)

Oh that previous post was intended for flossy. Sorry, I'm not too used to forums that give such prompt responses!

So to annie: yeah totally hear you about the scar tissue! It's part of the reason I opted to not have the ovarian cysts removed, it wasn't necessary but was offered and I'm like I don't need more of that built up, I need less! Must have been disappointing that your adhesions came back. Just in general I'm of the pessimistic mind set that everything always comes back. Oops 

Being that I've never done an enema before it was a bit....messy. Not a pro by any means lol. Still concerned about how I'll pass the rest. Think I'll try another enema, Miramax, and dulcolax. I've never used the dulcolax before but senna has ceased to work for me at point. Thanks for keeping in touch!


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## flossy (Dec 8, 2012)

Blue2 said:


> Awesome post! I could relate to so much of what you said. I think I've tried to ignore it or tough it out for too long. It's nice to read what's worked and what hasn't for other people.


Thanks! Prune JUICE also works really well for me - too well - I can't even drink a cup of it without an intestinal meltdown of sorts. You might wanna try that too.


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## annie7 (Aug 16, 2002)

oh i expected the adhesions to come back. that's what always happens. you can never get rid of them permanently. i had to have the lysis of adhesions surgery to free up my intestines. the first surgery was over five hours long. the surgeon said the adhesions had twisted my colon and small intestine into pretzels.

good luck . hope the enema/laxatives work.


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## johnnylakis (Mar 11, 2017)

I am very sorry to hear that doctors continue to remove gall bladders without good reason. In your case, if it was about to rupture, then you had no choice. I have had gall bladder issues for over 20 years and by taking Urso 250mg on and off have been able to keep my gall bladder. Unfortunately, as you show, gall bladder removal does not necessarily mean relief from gall bladder issues. From speaking to others who had their gall bladder removed, I find that a very fatty meal seems to result in a bowel movement.

With regards to Linzess, it is not meant to be taken everyday, as it will result in resistance to the medicine. Linzess should be taken daily until you have a bowel movement (usually within 3 days) and then stopped. I find it more effective to take at dinner time. Eat a small starchy dinner, wait one hour, then have a chocolatey dessert. Small bowel movements should happen throughout the next day.


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