Weaning Off Miralax: Adult Edition

Miralax, a polyethylene glycol (PEG) drug, is a common prescription for constipation. However, extended use may lead to malnutrition, particularly in young children and older adults. The FDA has also issued warnings about potential neurocognitive side effects. The recommended usage is no more than 7 days, after which a doctor should be consulted. To wean off Miralax, some people have tried natural supplements such as magnesium and vitamin C, as well as dietary changes like removing dairy and gluten. Others have had success with Heather's Tummy Fiber and Prunelax Tea. Acupuncture has also been suggested as a possible treatment for constipation.

The dangers of long-term Miralax use

Miralax is intended for the short-term treatment of constipation. However, in some cases, it is used long-term to treat chronic constipation. The long-term use of Miralax and other laxatives is usually only recommended for up to a week. Overuse of Miralax can lead to several health issues.

Diarrhea and Dehydration

Diarrhea is a common side effect of Miralax, and it is more likely to occur in older adults. Diarrhea can cause fluid loss and dehydration, which is especially dangerous for older adults.

Mineral Imbalance

Overuse of Miralax can cause a mineral imbalance in the body, such as low sodium levels.

Allergic Reactions

Although rare, some people may experience allergic reactions to Miralax, including anaphylaxis, which can be life-threatening.

Malnutrition

The extended use of Miralax may result in severe malnutrition-related disorders, especially in young children and older adults. This is because Miralax blocks the absorption of nutrients in the small intestine, which can lead to vitamin and mineral deficiencies.

Kidney Damage

Miralax has been linked to nephrotoxicity, or kidney damage, when used long-term. This is particularly dangerous for patients with kidney disease.

Neuropsychiatric Events

The US Food and Drug Administration (FDA) has warned that Miralax and other laxatives containing polyethylene glycol may be associated with neurologic disorders such as autism, dementia, depression, and schizophrenia. These conditions may result from the neurotoxicity of the drug and the malnutrition it can cause.

Encopresis

The involuntary passage of stools is a nasty side effect of taking Miralax, especially in children. This is due to the drug's effect on the large intestine, causing continuous leakage of semi-formed stools.

Dysbiosis

Miralax can cause dysbiosis, or a deficiency of intestinal bacteria, which can lead to a range of health issues, including premature aging, type 2 diabetes, facial wrinkles, weak nails, tooth loss, arthritis, and osteoporosis.

Rectal Damage

The use of Miralax with a high-fiber diet can lead to straining during bowel movements, which can cause enlarged hemorrhoids, anorectal nerve damage, anal fissures, diverticular disease, and rectocele.

Laxative Dependence

Long-term use of Miralax can lead to a dependence on laxatives, making it difficult to stop using them without experiencing constipation.

Natural alternatives to Miralax

Miralax is an over-the-counter laxative that increases the amount of water in the intestinal tract, making it easier to eliminate bowel matter. While it is FDA-approved for adults, many people are concerned about its side effects and are looking for natural alternatives. Here are some natural alternatives to Miralax for treating constipation:

Dietary Adjustments

• Increase Fiber Intake: Consume more fruits, vegetables, legumes, whole grains, and other fiber-rich foods. The recommended daily fiber intake varies with age. Children under 3 should eat 19g of fiber, while those between 4 and 9 should consume 25g. Anyone over 9 years old should aim for 30 grams of fiber daily.
• Stay Well-Hydrated: Drink plenty of water to soften stools and make them easier to pass. Young children should drink 3-6 glasses of water daily, while teens and adults should aim for 9-14 cups per day.
• Reduce Dairy Intake: Dairy products can increase constipation. Try eliminating cow's milk and other dairy from your diet and opt for dairy-free alternatives like almond or coconut milk.
• Add Prune or Pear Juice: Prune and pear juice are known natural remedies for constipation. Pear juice is a good alternative for those who find prune juice too strong.
• Increase Magnesium Intake: Magnesium is a natural laxative that relaxes the bowel and pulls water into the intestines, softening the stool. It can be found in leafy green vegetables, beans, nuts, and dark chocolate, or taken as a supplement.

Lifestyle Changes

• Increase Physical Activity: Regular exercise helps intestinal muscles contract and relax, aiding stool movement. Aim for at least 60 minutes of physical activity daily for both children and adults.
• Use a Squatty Potty: This is a stool that raises your legs above your hips, placing you in a natural squatting position while using the toilet. This posture makes it easier to empty your bowels and reduces straining.

Natural Laxatives

• Probiotics: Probiotics promote the growth of beneficial gut bacteria, aiding digestion and softening stools. They can be found in yogurt, cheese, miso, fermented drinks like kefir and kombucha, and probiotic supplements.
• Coconut Oil: Coconut oil has properties that aid in the faster breakdown of food and increase the frequency of bowel movements. It can be consumed in teaspoons, mixed with fruit juice, or used for cooking.
• Olive Oil: Olive oil acts as a lubricant, speeding up bowel elimination. It is also rich in antioxidants, promoting a healthy digestive tract. Like coconut oil, it can be consumed directly or used in cooking.
• Lemon: Lemon juice, especially when mixed with baking soda and water, stimulates the digestive system and assists in elimination. Drink it first thing in the morning or after a meal.
• Dandelion: Dandelion leaves or dandelion vinegar can be added to food or steeped as tea. It has traditionally been used to treat constipation, diarrhea, and inflammation due to its vitamin and mineral content.
• Fish Oil: Fish oil, rich in omega-3 fatty acids, acts as a lubricant and provides vitamins and minerals that help waste pass through the bowels. Good sources include salmon, mackerel, halibut, tuna, and sardines.

It is important to consult with a healthcare professional before making any significant dietary or lifestyle changes to ensure they are suitable for your specific needs.

The importance of gut health

The gut microbiome is the foundation of your health. It is made up of trillions of bacteria, fungi, and other microbes, which are collectively known as the microbiome. The gut microbiome acts as an extra organ in your body, playing a crucial role in your health.

Good gut health occurs when there is a balance between the good (helpful) and bad (potentially harmful) bacteria and yeast in your digestive system. This balance is called equilibrium. The "good" bacteria help with digestion and keep the "bad" bacteria in check. They multiply so often that the unhealthy kind don't have space to grow.

The gut is physically connected to the brain through millions of nerves. The gut microbiome may affect brain health by helping control the messages that are sent to the brain through these nerves. Studies have shown that people with various psychological disorders have different species of bacteria in their guts compared to healthy people. This suggests that the gut microbiome may affect brain health.

The gut is also where your body gets rid of metabolic waste and toxins. If you have an unhealthy gut, your body will struggle to rid itself of those toxins, which can cause issues such as chronic fatigue, chronic illnesses, and inflammation throughout the body.

An unhealthy gut can also lead to autoimmune disorders like Hashimoto's Disease, rheumatoid arthritis, Type 1 diabetes, and multiple sclerosis (MS). Brain fog, headaches, poor concentration and memory, fatigue, chronic pain, trouble sleeping, and issues with cravings or bad moods are also symptoms and critical indicators of a poor microbiome.

To improve your gut health, you can manage your stress levels, practice mindfulness, eat healthily, get 7-8 hours of sleep a night, and exercise. Eating a wide variety of high-fibre and fermented foods supports a healthy microbiome. Taking probiotics and limiting antibiotics can also be beneficial.

Dietary changes to improve bowel movements

Making dietary changes can be an effective way to improve bowel movements and relieve constipation. Here are some dietary suggestions to help wean off MiraLAX:

Increase Fibre Intake:

• Consume more fruits, vegetables, whole grains, legumes, and pulses.
• Aim for five servings of fruits and vegetables daily, plus whole grains.
• Examples include apples, pears, prunes, kiwis, broccoli, beans, lentils, and peas.
• Try overnight refrigerated oatmeal with fresh blueberries or add prunes for extra fibre.
• Include high-fibre cereal and bread in your diet.

Stay Hydrated:

• Drink plenty of water to prevent dehydration, which can lead to hard and dry stools.
• Be cautious of trendy beverages like kombucha and cranberry juice, as they may not offer the claimed bowel health benefits and can contain high amounts of sugar.

Healthy Fats and Oils:

• Include flaxseed in your diet, as it contains omega-3 fatty acids and has lubricating properties.
• Olive oil and flaxseed oil may have a mild laxative effect and improve digestion.

Probiotics:

• Probiotics may improve gut health and soften stools.
• Try yoghurt, kefir, and sauerkraut, which are natural sources of probiotics.
• While the effectiveness of probiotics for constipation is still under discussion, there is no harm in trying them to see if they work for you.

Physical Activity:

Engage in regular physical activity, as sedentary lifestyles can contribute to constipation.

Remember to make gradual dietary changes and introduce new foods incrementally to avoid discomfort and bloating. If you are unsure about your diet or experiencing persistent constipation, consult a healthcare professional for personalised advice and guidance.

The Bristol Stool Chart

• Type 1: Separate hard lumps that are hard to pass, indicating constipation.
• Type 2: Lumpy, hard, sausage-shaped stools, which are also hard to pass and may indicate constipation.
• Type 3: Sausage-shaped stools with cracks on the surface. These are considered well-formed and easy to pass, making them ideal stools.
• Type 4: Sausage-shaped or snake-like stools that are smooth and soft. Like Type 3, these are considered normal, healthy stools.
• Type 5: Soft blobs with clear-cut edges that are easy to pass. These are considered borderline diarrhoea and may indicate a mild gastrointestinal issue.
• Type 6: Fluffy pieces with ragged edges that are mushy and considered diarrhoea. This type of stool can be caused by a lack of fibre or a mild infection.
• Type 7: Entirely liquid, watery stools with no solid pieces, indicating very loose stools or fully liquid diarrhoea. This type of stool may be caused by viral or bacterial infections, parasitic infections, or medical conditions such as celiac disease or Crohn's disease.

Frequently asked questions