# Question about increasing miralax dosage



## em3092 (Dec 5, 2014)

Hi, I'm a new user so sorry if this isn't posted in the right place. Anyway... I've been taking Miralax for IBS (mostly C) for about four months now. I had been taking one capful a day and it was really helping, I was having more regular BMs, etc.

As of a couple weeks ago, though, I've been starting to feel constipated again - having to strain badly to have very small BMs. I increased the Miralax I was taking to about a capful and a half and that seems to be helping. My only concern is if I'm becoming dependent on it and if I'll have to keep increasing dosage as my body adjusts to it? Is that a danger with Miralax?


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## annie7 (Aug 16, 2002)

HI and welcome to the board.

both my gastro docs, my primary doc and my surgeon have all told me that miralax, being an osmotic laxative, is safe to take and that it was safe for me to take as much of it as i need on a daily basis--that i could take two capfuls daily or even more if i need to. i know of other people who were told the same thing and who take a double dose or more daily. i also know of people who have taken the same dose of miralax for years and never had to increase it. i've not read anything that says that one's body adjusts to it and that you'll keep having to take more. and i've never been told that by my doctors, either.

but of course, it's always best to ask your doctor these questions since your doc knows your medical history etc. your doc's advice is always best.

if your constipation problems continue to worsen you might want to look in to having some tests to see what is causing this--such as a sitz marker test to test for slow transit constipation (colonic inertia) or a defecography (defecatory proctogram) and/or an anal manometry to see if you have pelvic floor dysfunction or any other outlet problems.

there's a lot of good tips and information on dealing with constipation etc over on the constipation board. and there's a number of posts about miralax over there too. you can do a search.

good luck. wishing you all the best.


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## em3092 (Dec 5, 2014)

Hi, thanks for the reply. That makes sense with what I know of Miralax, too, it just can be worrying when something that had been working fine suddenly starts affecting you differently.

I will definitely check in with my doc if things get worse.

And thanks for the advice on where to look for information!


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## annie7 (Aug 16, 2002)

oh yes--i agree--i definitely know the feeling when something that had been working fine for me decides to stop working or not work as well....

i know it's hard , but try not too worry too much. that can just make you tense--particularly when you are sitting on the toilet trying to go. being tense can tighten up the pelvic floor muscles and make it harder to go.

have you tried elevating your feet on something like a footstool, shoebox etc while sitting on a toilet. doing this helps to straighten out the anorectal angle and allow for a more complete evacuation. so can using a squatty potty (available on amazon and elsewhere) i put my feet on a large shoe box. some people can actually manage to squat on the toilet and find that helps.. it can take some experimentation to find out the right height for your feet but it can help.


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## em3092 (Dec 5, 2014)

I haven't tried elevating my feet, I have heard that that's something that can help, though. I should probably give that a shot. Anyway, yeah, trying not to worry too much. The worrying always gets me, which of course only makes things worse.


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## annie7 (Aug 16, 2002)

yes, i was surprised at how elevating my feet helped.

there's also this video on how to have a bowel movement without straining. straining just makes things worse--it locks up the pelvic floor muscles so that it's even harder to get stool out. i've posted this video before on the constipation board so maybe you've already seen it. this woman is quite good. her instructions are a lot like the ones my pelvic floor biofeedback PT gave me:






the "belly breathing" really helps. and pushing from the belly, not the rectum. "making your waist wide" like she says. and relax the rectum--don't strain or push with it.


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