Need to get off miralax

Hi ch783e933 @user_ch783e933

I actually have redundant colon and many who have it use drugs like Miramax. For me it wasn't worth it so I did the following:

Disclaimer: This is only my experience going natural. I have used organic, integrative, functional, holistic Naturopathic doctor's advice along with my MD’s since the early 1980's. There is science in alternatives too. Because I work closely with my ND, he told me to study the Migrating Motor Complex and Osmotic Gradient and he bet that I would find what worked for me. How to keep a longer than normal pipe with consistent moisture…. My ND also said because my condition was physical, attention would be needed from now.
I tried laxatives and they are not consistent and have side effects like bloating, etc. All say for occasional use. They disrupt the system if take continuously. I liked a response from a co-redundant colon person: “It’s physical” so regular constipation suggestions may not work. Don’t give up because it took me 4 months to feel I could depend on being regular. It is worth going natural.
Last Dec the doc had me do non sedated colonoscopy. He could get through my colon as I watched on TV. I had had a baby years ago (natural and could stand pain) so figured I could stand it – it was no big deal. Most people in world don't get put out. Very interesting and it helped allow the scope to get through because I relaxed. No wonder I had been constipation on and off starting in my teens. I’m now in my early 70’s.
OptiMag and K2+ Potassium are great supps. I take them when I go to bed and once when I get up to pee. I include prunes/prune juice, winter squash, sweet potatoes, rhubarb etc in my diet. I eat cups of steamed vegetables each day. I like to grind 2T chia, 1 T sesame seeds and 2 T flax seeds, then soak in prune juice overnight. I add a T of carob now since it can help regularity. Take half in the morning and half at night. Throw sugar out along with processed and refined foods. Look up foods and drinks that constipate and give them up. Drink lot of water starting with a quart of hot water in the morning - boyscouts. I use warmed up diluted chicken broth at times too. It is soothing to my stomach. Coffee and Smooth Move are my back ups. I don't like coffee and never have drunk it much but it usually works for me in a pinch. Thankfully I only need coffee a few times a month.
Check out helpful research of biological processes that take place in our gut:
- Migrating Motor complex which is the electroactivity in the GI tract during meals and fasting
- Osmotic gradient. If too much water is pulled into the colon, diarrhea results. If not enough water is pulled into the colon constipation results. Balance of minerals is important. Magnesium, potassium and sodium brings water into the colon. I have found balancing these help prevent constipation. I have to watch my calcium intake because it tends to encourage constipation. Calcium carbonate seems to be the most constipating. I depend on blood work from time to time to make sure my minerals are balanced.
Good luck, don't give up and blessings, @farmersmith

I’m confused about why you’re trying to get off Miralax if it’s helping you. Is it because you want to address the “root” of what you think is the problem, the motility caused by gut dysbiosis?

If so, that’s understandable, but Miralax is safe to take long-term. Some people need to take it long-term. And taking it regularly can improve motility, thereby in time rebalancing your gut microbiome.

As you found, “natural” solutions such as probiotics aren’t without side effects. They can cause gas, constipation, or diarrhea.

There are other ways to manage constipation and motility if you want something more natural. Sunfiber (there are generic brands), psyllium fiber, or I use magnesium citrate supplements (the capsules, not the liquid). My PCP recommends at least 400 mg for constipation. Or there is a product called Natural Calm, which mixes into a drink and is magnesium citrate when mixed with water.

I saw a GI dietician to help me figure out safely what foods work best for me and expand my diet, a pelvic PT who taught me abdominal massage techniques, and a GI psychologist who taught breathing practice and does gut-directed hypnotherapy. So they all had knowledge and taught things that my gastroenterologist knew of, but fell without her specialization.

All of the above can help reset the gut microbiome in time. But If tackling your gut microbiome directly is your goal, that’s more challenging and less clear. While research is clear that the gut microbiome is important; it’s less clear how to address it. That’s probably why you’re doctor has little or nothing else to suggest if you’re asking them that question—what they do know if Miralax is safe taken regularly; what they don’t know is what’s going on with your gut microbiome and/or how to address it.

The one thing I can think of is you could ask to be tested for SIBO. But some clinics or medical centers don’t do that and have to be willing to order the test kit for you.

If you really want to take a different approach, you may want to consider getting a second opinion with a gastroenterologist at an academic medical center that would be more likely to have a team of a GI psychologist, GI dietician, and/or pelvic PT. Or you could consult any of the above on your own; I’d just suggest specifically a GI-trained dietician.

Or look for a naturopath or integrative medicine provider. I don’t have personal experience with a naturopath; it’s always made me a little uncomfortable, but that’s just me. My PCP is an integrative medicine provider though.

I have many similar symptoms! It’s very frustrating. Mine started with constipation 2 years ago. After being under gastroenterologist care since then, and daily Miralax, recovered normal BM for couple of months after B12 deficiency diagnosis and treatment. THEN, diarrhea bouts, after lots of salad. NOW C again! Gastro prescribing SIBO test, though I have no pain, no bloating, no nausea, etc. And meeting with gastro dietitian. Til then, going to return to Miralax. No choice really. My stomach gurgles. I’ve laid off salads. I see a talk therapist every 2 weeks. I’m open to psychological treatment.

Colonoscopy scheduled for late Oct. Screening one in 2020 was good.

I feel great, have good diet, work out and am desperate to get this behind me. (Pardon the pun. Lol)

Salad (lettuce) is notoriously hard to digest, as are all raw vegetables. And it causes gas because it ferments in the bowel. Adding anything to your diet when you have an increasingly sensitive digestive system has to be done very slowly. So you eat a very small salad along with something you know doesn't cause problems (usually) and increase very very slowly until your body adjusts. This can take weeks, maybe never will actually. As we age, I'm discovering very unwillingly, our body changes how it works. I went from eating anything I wanted without thinking about it to having to think twice before eating anything, especially something new in my diet, over the past 20 years. Since the moron in the ER literally messed up my body for the rest of my life (it seems), my diet has become increasingly restricted. Happily, or probably more likely quite unhappily, I don't care about eating any more so I do it just to survive. I'm only 5 feet tall and very petite, the size of a twelve year old probably, but I went from 120 pounds to 105. That's not good. I haven't weighed 105 pounds since I was in my late 20s. When you're old, you need some weight to lose, just in case. After the December fiasco with the augmentin poisoning, I ate very unhealthily, cake, cookies, ice cream, and actually got back to about 115 pounds but since then I've lost it because I stopped eating that way. I don't know anything about SIBO except that it seems to involve the small intestine. If your stomach gurgles since starting miralax, you probably don't need it, or you should use the minimum. Start with 1/4 cap, add only if there's a problem with C. Unfortunately, I've become an expert at this and if only I could get off this junk and go back to normal life, but that's obviously never going to happen. The gut is tied to the brain. Serotonin actually exists in the bowels. So this disruption of bowel biome has further influenced for the worse my already horrifically poor thought process and feeling of hopelessness, pointlessness, and a really strong desire to never wake up one morning. Good thing I'm at an age where people drop dead. I hope you're able to resolve your problems.

Unfortunately, I moved from a very sophisticated place (Long Island) to a place where you need to do heavy research to find a real doctor, so the things you describe in terms of the treatment you received do not exist here, I can almost guaranty that. There is a teaching hospital an hour away, I have two physicians there, and the director of Gastroenterology was highly recommended. When I'm done with this horrific colonoscopy nightmare end of October, I'm going to make an appointment with him to discuss the issues. Unfortunately, winter is coming and driving an hour in each direction on the Thruway is tricky because you never know when it will snow or be icy and the Thruway is notoriously filled with lunatics, especially the truck drivers. Apparently, the career truckers are more and more difficult to find and the drivers in their place are actually homicidal maniacs. Who knew this could happen.

I don't think there' sa PCP "integrative medicine provider" within a 3 hour ride of me. Downstate, we have NY Presbyterian extension and I think NYU Langone is somewhere in Westchester now. But basically, I left a place with state of the art medicine (NYU Langone has a huge facility on Long Island now, and there's North Shore University LIJ and a couple of others) for a place with corporate "doctors" who resemble AI robots but don't know as much.

I don't have SIBO. I have none of the signs. I have a slow bowel which is most likely related to insufficient water intake as I'm totally unable to drink lots of it. And age, of course. Also, can't take any supplements with fiber. Fiber is what caused the bowel inflammation last December, I started eating peas with dinner, lots of peas. Miralax helps that along. I know at least one person who has been taking Miralax for a very long time, but she's 94. I have 20 years to go, hopefully not, since my quality of life at this point is non existent. I wish I could take your recommendations. Honestly, the Nutrition Center across the river here is still stuck in a community hospital in a quaint rural Mid Hudson Valley town, i.e., medical care stinks. I really don't trust them. I've used Calm, did nothing. The problem here is that I can't stop the Miralax to experiment with magnesium citrate because I will get constipated as a reflex to withdrawal and then the hemorrhoid and anal rim discomfort will get worse and I'm more likely to go off the Rhinecliff Bridge.

Thanks for your comments, very educated, and very good ideas, but might be impossible to achieve where I live. I'll do some research.

I had a totally unmedicated mid forceps delivery after induction and there is no way in hell I would ever have a colonoscopy without sedation. Wouldn't do that to a dog. I've had 3 colonoscopies, my colon is not redundant.

Can't eat fibrous foods without great care and certainly can't take any fibrous stuff like psyllium ets. metamucil is totally out of the question. When the stool thickens, it slows motility and increases effort to expel it. You can't do that with a persistent hemorrhoid. At my age, hemorrhoidectomy is totally not doable and it doesn't really work anyway. Most of them come back, weeks of real pain, potential infection on surgical site, lots of addictive pain killers which worsen constipation and so another hemorrhoid is born. Not gonna happen. So what worked for you won't work for me, but thanks for the info.

Absolutely we are all biochemically individual and have to suit our food and lifestyle to match us. Best to you and finding more keys for health and relief.
@farmersmith

Ahh, I see. Believe it or not, although I live in a large metropolitan area, it has taken me years to amass the resources I mentioned.

I’ve had chronic pain for years at this point, and the default has been having to do research and advocacy on my own. It’s frustrating for sure.

There is a type of SIBO (methane dominant) that causes slowed motility and constipation, and it is harder to diagnose via breath test than the other one. But if you feel you’ve ruled it out, totally respect that.

Most of this I learned from various books and online resources if finding a provider is out of reach. They specifically focus on patient education and self management because it’s so difficult to get help for gut issues. For example, if you were interested in abdominal massage to help motility, there are YouTube videos by pelvic PTs available online.

I’m also thinking of one author who’s a GI dietician who structures her books as diagnostic quizzes similar to what she uses in the clinic—her books helped me. And many GI dietitians provide services virtually and across state lines, which insurance can cover unless you have Medicare. In that case, Medicare stupidly doesn’t cover a dietician except in highly specific cases. Cash pay adds up but someone who’s the right fit could be really helpful. Integrative or holistic doctors also tend to offer virtual visits, especially if you find someone in-state.

There’s even a GI dietician/psychologist team I follow who just put out a book and started a podcast focused on actionable tips. I’m happy to list some of them off in case you want to look into them for your research. I can send some along when I’m in a spot where I’m sitting still, but no obligation.

I’m not familiar with your condition where fiber causes inflammation, but Sunfiber specifically is IBS-friendly and has been shown to help both diarrhea and constipation, and improve the amount of good bacteria in the gut. It’s very well-tolerated (and I say this as someone who usually doesn’t tolerate things that are well-tolerated), but it sounds like you may have a different condition.

With hydration, I have POTS, which requires a lot of fluids but like you said paradoxically GI symptoms make it hard to take in fluids. So I rely on electrolyte supplements (Klaralyte is in capsule form) and electrolyte solutions—Skratch Labs and Tailwind make good low sugar (real sugar is required for electrolyte solutions to work properly) and sugar-free versions without fake sugars that don’t taste horrible. The electrolytes help your body absorb more water (as opposed to losing it through urine and sweat) so it’s especially helpful for me because I struggle to take as much in. I’d like to think it also helps the constipation.

It’s super frustrating, but there are options.

Good Morning,
I take Miralax every morning and Senna at night. It won't hurt you. I would go to another gastroenterologist if you are unhappy with the one you have. Sometimes all it takes is a switch in doctors.

Express your concerns. Good luck.

CindyC
CHrcc

I have hypothyroidism which contributes to constipation. I drink approximately 50+ ounces of water everyday (my only drink in addition to my orange juice and coffee at breakfast daily. I have been eating the Mediterranean diet which has improved my bowel movements and have lost weight (180 lbs down to 156 lbs). I exercise 1 hr walking on treadmill on a weekly basis. My GI recommended me to take Myralax daily (3/4 cap) after I went to visit him to check my hemorrhoids that were bothering me. Since I bled from one of them he performed a Rubber Band Ligation right at the office same day of visit. Painless. Then he told me to take one Colace cap twice a day. So far I have been having good Bowel movements without discomfort. My nutritionist told me keep doing what I have been doing in addition to add Ground Flax Seed to my yogurt and oh boy you really get bowel movements but no diarrhea. Having hemorrhoids is not pleasant but all of this has been working for me. My quality of life definitely has changed, I am now 72 yrs old but sticking to everything I have been doing to avoid constipation changes anyone. Now if I travel the first things I make sure to put in my carry on are my constipation meds, before it was bathing suits, sun blockers and shorts. Everything changes but I prefer to feel good and not constipated. I wish all of you who are going through so much good health and a good life.