# What is going on? Movicol (Miralax) question



## Aidara (May 9, 2014)

Hello everyone. Can somebody help me to figure out what is happening, please.

I had been very successful with Movicol for about 8 months. These days something strange is happening when I am taking this medication (2-4 sachets per day). I have soft stools (I suppose it means that Movicol is working), but I have no urge to go or if I do, it is very little urge. As a result I have to strain more then usually, I get either complete constipation or incomplete evacuation. I am also taking 1-2 sachets of fybogel. Why is this happening? Does it mean I should add some stimulant laxative, which I am avoiding at all price. If I increase the dosage (4-5 sachets of Movicol), then I get very soft stool (almost diarrhoea), but at least I go yet I still don't have strong urge. Looking forward to your advice, thank you.


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## Kathleen M. (Nov 16, 1999)

It might be worth talking to the doctor to see if you need pelvic floor testing to make sure everything is working OK at the outlet since you have the stool consistency such that it should be OK.


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## annie7 (Aug 16, 2002)

Hi Aidara

so sorry you are having this problem. i have it too--little or no urge-- which in my case is due to several problems--my slow colonic transit as well as--as Kathleen mentioned--my pelvic floor problems and i also have rectal hyposensitivty and megarectum, as dx'd by my anorectal manometries.

as Kathleen mentioned, i do hope you can see a doctor soon who will order the pelvic floor tests you need. hopefully your colorectal surgeon will do that at your upcoming appointment. and then you can take a course in biofeedback which should help resolve the issue by teaching you to relax those muscles..

it's easier to get and feel the urge when your pelvic floor muscles are relaxed. one simple exercise to do for this is to gently squeeze your pelvic floor muscles--your anus-and then relax it . squeeze just enough so that you can "get the release" as my pelvic floor PT puts it--- get the relaxed feeling. this helps you identify your pelvic floor muscles and also helps you to relax them.

here are two exercises she told me to do. i still do them daily sometimes just doing these exercises gives me the urge a bit:

1) slow contractions: contract your pelvic floor muscles for 5 seconds (gently) then relax them for 5 seconds. 10-15 times in row, twice a day. always relax for at least as long as you squeeze.

2) quick contractions: contract your pelvic floor muscles gently for 1 second and then relax for 1 second. again, never hold your breath while doing this.

in the meantime--have you tried elevating your feet by placing them or a shoe box or foot stool etc while sitting on the toilet and/or relaxing your belly and belly--breathing--breathing from the belly not higher up--when sitting on the toilet. this does help me get a better urge when i just have a weak one going. and be sure to relax your pelvic floor muscles while you are doing this--don't tense up and strain. also some people find leaning forward while on the toilet and resting your lower arms (from the elbow on down) on your legs helps them go/get an urge. relax and do the belly breathing too while your doing that, and when you get an urge, push from your belly--make your waist wide--don't strain/push with your rectum. . that u-tube video that we've posted on some of your other threads has a great description of all the methods i just described.and i have the link to that listed on my profile too.

does drinking black coffee or another --preferably warm or hot--caffeinated drink like tea with caffeine in it help give you the urge at all? lots of people--myself included--find that this helps too.

does using a plain glycerin suppository help you get an urge? the plain glycerin ones do not have a laxative in them. they are just glycerin (soap)--no laxative. . all my docs have told me they are safe to take.

good luck. i do hope you can get to see your colorectal surgeon--or a good gastro doctor-- soon so you can get these tests etc.


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## Aidara (May 9, 2014)

Thank you so much for your response. I am pretty sure that my constipation is related to my pelvic floor muscles. I am still waiting for my colorectal surgeon appointment. Unfortunately, there is ridiculous waiting times in UK, so it will take months to get my pelvic floor tested.

Annie, I don't know why, but I don't feel much of difference when I elevate my feet or if I do breathing exercises.  If I don't have urge it means I don't, nothing makes me have it.  I have my morning routine and only specific things makes me go - hot water, coffee and breakfast. If I don't go after those three, I don't go at all. I can't stop thinking, how is this possible, that I had a good urge when taking Movicol for a good 8 months and all of the sudden I lost it? What pelvic floor muscles has to do with peristalsis? I thought pelvic floor muscles are responsible for pushing stools out, but peristalsis comes from inside. Am I wrong? What would you advice me to do in the meantime? Should I increase Movicol to the point I have pure diarrhoea or should I add some other laxative? I am so confused what to do and praying to get my appointment soon.


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## annie7 (Aug 16, 2002)

Yes pelvic floor muscles help push stool out but if they are too tight and stool cannot get out then peristalsis slows.

you could try more movicol or a stimulant,yes.


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## annie7 (Aug 16, 2002)

Or you could try some of the great suggestions dream catcher gave you.


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## Aidara (May 9, 2014)

Thank you Annie, Ill keep trying new things. Thank you for your help and support.


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## annie7 (Aug 16, 2002)

oh thanks--you're more than welcome, as always.

good luck with everything. and so sorry the wait times to get in to see a specialist are so ridiculously long there. i've heard other people in the UK say that as well. we have long wait times here but not near as long as you do. of course it must be nice to have the NHS pay for so much but those wait times sure do make it hard, don't they.

please do take good care.


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## Aidara (May 9, 2014)

Thank you Annie. I am so grateful to you and other people on this forum, who has helped me to understand my symptoms better. So far every combination I try works for a short time only, but at least I know what could be happening with my body. The more I pay attention to my symptoms, the more I feel that my bowel is fine, but the problem is in my pelvic floor muscles. I would have never understood it if not this board. Once I get the right diagnosis, at least doctors will be taking me more seriously. Many thanks to you and to all other members who's been helping me finding the answers.


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## dianag723 (Jun 27, 2014)

I have had the same problem with mirlax. Not the wonder drug they say it is. Switch to a stimulant laxative like senokot or milk of mag but be careful not to become to used to them or they will cause you to loose your desire to defecate. If you can eat some fiber, do that, like oatmeal. Drink lots of water. Laxatives continued use are not good. Sometimes we have no other choice but beware soft stool can slip by hard and cause an obstruction down the road.. Talk with a GI doctor and get some help.


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## Jinky (May 23, 2014)

I have pelvic floor dysfunction and Mirlax proved not to be my friend. As a result of the pelvic floor dysfunction I have obstructed outlet dysfunction/slowed colonic transit. The Miralax made me bloat, softened things up, but the stool was difficult to evacuate so I would I many multiple incomplete evacuations of soft stool. I never felt like I was completely "done", always bloated and cramp-y. Sennakot and MOM is a much better choice for me. I use it 3X a week.

Your information about laxative use, I disagree with. I have checked out continued use of the sennakot/MOM mix with my doctor and he said it was OK. Other members here use MOMw/a stimulant w/OK by their doctors. The "soft stool slipping by hard" remark by itself I find puzzling. I find I either have one stool consistency or another. And fiber.....if you have slow transit, fiber is not your friend, each of us is individual and has to experiment as to what will bind or not. Personally, I find oatmeal (big on the "soluble fiber recommendation list) sits in my gut like a lump going nowhere, fermenting, causing bloat like nearly all starches except for yams and potatoes. Drinking lots of water....always a plus.


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