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Suggest Medication For IBS While On Miralax

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Posted on Thu, 4 Feb 2016
Question: I suffer from Iritiable Bowel Syndrome. I take Miralax daily for this, 1/2 capful in morning, and a capful at night.
On my last appointment with my doctor, I told her I was having occasional times when my bowels were not moving. I also take a stool softner, so my stool stays soft. She prescribed me a laxative Lactulose Solution
gm15, to take when this occurs, in addition to my Miralax. I had to use it last week, 6 teaspoons on Monday 12/28 and 4 teaspoons on Tuesday 12/29. By Tuesday evening it was beginning to work like the medications (citrate of magnesia) you take for the prep for a colonoscopy. Once I was cleaned out. it worked less frequently, but has continued to work every time I eat. It starts about 3:00am, each night, and continues into the late morning. I am still not producing any stool, only liquid bowel movements. Tuesday I cut my Miralax to 1/3 a capful at night. I am afraid to take pepto bismo, to attempt to stop this, because it allways constipates me. I talked to my doctor last Saturday, 01/02, and she said it would take time to get back to normal bowel movements. Should I be concerned, or just wait this out.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
It sounds like the lactulose was too much for your IBS.

Detailed Answer:
Hello and welcome,

I am sorry you are having this problem. Rather than adding lactulose when you are having difficulty having regular bowel movements, have you tried a bulk former like Citrucel? With any fiber/bulk former, you need to start with small amounts and increase slowly. This is something that you would take every day to help control the IBS. Of course if you have an episode of prolonged constipation and discomfort from constipation, then occasional lactulose would make sense. But now that you know how your body reacts to it, I would suggest using much less of it.

I might hold off on the Miralax entirely right now - at least for the next day and see if that helps.

Also, consider cooking rice (such as brown basmati) in extra water and for longer duration than required and eat a half portion of it. This can help slow things down a bit. This is not something to do every day but just while you are having liquid movements. This can be constipating, so discontinue once BMs are closer to normal.

I would skip the Pepto Bismol. That is more appropriate for a gut infection or food poisoning. And yes, it can be constipating.

I hope this information helps.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3134 Questions

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Suggest Medication For IBS While On Miralax

Brief Answer: It sounds like the lactulose was too much for your IBS. Detailed Answer: Hello and welcome, I am sorry you are having this problem. Rather than adding lactulose when you are having difficulty having regular bowel movements, have you tried a bulk former like Citrucel? With any fiber/bulk former, you need to start with small amounts and increase slowly. This is something that you would take every day to help control the IBS. Of course if you have an episode of prolonged constipation and discomfort from constipation, then occasional lactulose would make sense. But now that you know how your body reacts to it, I would suggest using much less of it. I might hold off on the Miralax entirely right now - at least for the next day and see if that helps. Also, consider cooking rice (such as brown basmati) in extra water and for longer duration than required and eat a half portion of it. This can help slow things down a bit. This is not something to do every day but just while you are having liquid movements. This can be constipating, so discontinue once BMs are closer to normal. I would skip the Pepto Bismol. That is more appropriate for a gut infection or food poisoning. And yes, it can be constipating. I hope this information helps.