# Is Miralax (Polyethylene Glycol 3350) FODMAP safe?



## Zelda

Here in the US, Miralax, which is an osmotic laxative (Polyethylene Glycol 3350), is quite popular. It is often recommended for IBS. I am aware that sugar alcohols like manitol, sorbitol, xylitol, etc, are no-no's. While Miralax has a chemical that ends in "ol" (Glycol), I am uncertain if it is a sugar alcohol, or something that should not be used if on FODMAP diet. I've searched the web high and low and cannot find anything specific. Anyone understand how to figure it out? Here is the chemistryI find that it relieves the pressure in my gut, when it gets painful. I deal more with IBS-C right now.


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## Zelda

I think I found the answer to my own question.


> *Polyols*, also known as sugar alcohols (appearing as artificial sweeteners in commercial foods and drinks):Sorbitol may appear in "sugar-free chewing gum", "low calorie foods"; naturally it appears in stone fruits: peaches, apricots, plums).Xylitol naturally appears in some berries. A pack of chewing gum containing sorbitol or xylitol may cause bloating or diarrhea in a healthy child and especially in persons with fructose malabsorption or SIBO.Other polyols, like mannitol, isomalt, erithrytol, arabitol, erythritol, *glycol*, glycerol, lactitol, ribitol, may be problematic in fructose malabsorption and SIBO.


Unless there is something else chemically, with the polyethylene that would cancel out the effects of the glycol, it would seem that products like Miralax should not be used by those on a FODMAP diet. That's too bad.


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## BQ

Well if it helps you...??? Isn't that the bottom line..?? to find things that help?As I have said many times before.. it isn't ALWAYS about Food! There are many triggers. Using a low FODMAP diet right now is "popular". It doesn't mean everyone doing it has a fructose malabsorption problem. And I don't think you should avoid a treatment that helps you in order to strictly adhere to a low FODMAP diet unless a Dr has diagnosed you as having fructose absoprtion problems.


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## QuiQui

I never thought about that before. I know I have terrible reactions to sugar alcohols, but polyethylene glycol never gives me any trouble. I'm trying to do a google search on the topic, but I'm not finding anything. This is the most helpful thing I've found so far:"Hyperosmolar laxatives are undigestible, unabsorbable compounds that remain within the colon and retain the water that already is in the colon. The result is softening of the stool. The most common hyperosmolar laxatives are lactulose (for example, Kristalose), sorbitol, and polyethylene glycol (for example, MiraLax). ... Hyperosmolar laxatives may be digested by colonic bacteria and turned into gas, which may result in unwanted abdominal bloating and flatulence. This effect is dose-related and less with polyethylene glycol. Therefore, gas can be reduced by reducing the dose of the laxative. In some cases, the gas will decrease over time."I also know that polyethylene glycol tastes more salty than sweet, so it doesn't seem likely that it would turn into sugar anywhere. Maybe it has to do with they "poly" part? Ethylene glycol (antifreeze) does taste sweet. Here's an explanation of the difference between polyethylene glycol and ethylene glycol:"Polyethylene glycol is a polymer while ethylene glycol is a simple diol. Polymers have very different properties from the monomer they were synthesized from (and from small molecules that are structurally similar to the repeat unit of the polymer). This is because of the difference in size and intermolecular interactions. PEG is very large compared to ethylene glycol."Here's maybe the most helpful things I found:"Polyethylene glycol (PEG) 3350 is a mixture of non-absorbable, non-metabolised polymers of mean molecular weight 3350 (±10%) that act as pure osmotic agents. It contains no more than 0.1% of lower molecular weight PEGs that are absorbable either in healthy subjects or in patients with inflammatory bowel disease, and are excreted unchanged by glomerular filtration.""In vitro study showed indirectly that Polyethylene Glycol 3350 NF was not fermented into hydrogen or methane by the colonic microflora in human feces."Maybe someone who actually knows something about science can put all this together properly, but my GUESS is that polyethylene glycol is safe.


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## Kathleen M.

Polyethylene glycol is considered to be unlikely to produce gas compared to osmotics like lactolose or sorbitol, and "it can be converted to gas" seems to be what puts something on the FODMAP-banned list (regardless of compound).The "Poly" could very likely overrule the "-ol" as this is a really big molecule made up of a bunch of small ones, and often what they hook it together with is the bits that would be a problem for the individual monomers that make up poly-So if it doesn't give you gas I would keep taking it. After all being constipated all the time isn't going to make you feel better and most of the foods banned in the fodmap diet are things that loosen up the stools and helps to keep them wet.That the data above says it cannot be fermented would also say "fodmap safe" as fodmaps are "unsafe" because they are fermented.


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## QuiQui

I'm still looking stuff up. I think I know the answer now, but feel free to correct me.Polyethylene glycol is not a sugar alcohol, it's a polyether compound. (But if it's an ether, is that different than being an alcohol?) Glycol (also called ethylene glycol) is definitely a sugar alcohol and is not the same as polyethylene glycol. (But you would never eat this because it's basically antifreeze.)There are two problems with sugar alcohols. One is that they have an osmotic effect (they attract and bind water), which can cause diarrhea. The second is that they don't get properly digested, so they ferment in the large intestine, which produces gas. If what I've been reading is correct, polyethylene glycol gives you the osmotic effect, but it doesn't ferment or get metabolized at all in your body. Therefore, it shouldn't give you gas. It passes through you unchanged. The question in my mind now is whether the real reason why sugar alcohols are a no-no in the FODMAP diet is because of their osmotic effect or because they give you gas. If you have IBS-D, obviously your should stay away from Miralax. If you have IBS-C, something that makes you poop without gas is a Godsend!


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## razzle5150

too much Mirlax makes me sick ... I can only take a couple of days and then it still doesnt work ... I am now on 6th day without pooping . and having alot of gas ....


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## KJL

If it works for you keep at it.I'm trying low-fodmap to help with my bloating and wind issues (the idea being to reduce the amount of food that ferments in the gut). I have IBS-C as well.It is all trial and error, and everyone is different.


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## nickychips

I have just been diagnosed with SIBO which is apparently the root cause of my IBS-D. I am supposed to follow a very strict diet for one month. (Dr. Allison Siebecker diet combining low FODMAPS with SCD) I've been on it now for a couple of weeks and now have the opposite problem: constipation! I am also taking antimicrobials for a month, prescribed by my naturopath, to kill off the bacterial overgrowth. I'm not supposed to have any sugar other than basic white sugar or honey during this period. Can I take Polyethylene Glycol?


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## jza

Many people with SIBO-C use Miralax with success.


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## JulieK

I have IBS-C and am on my fourth dose of powdered Restoralax (Canadian form of Miralax). I've had rumblings in my belly but not really pain and not much gas, but a lot of noise and bubbles moving around it seems. How long before I can expect this stuff to start working? I've read commonly three days so I'm hoping for success today!


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