When people suffer an occasional bout of constipation, most don’t worry about taking a laxative. Old-fashioned Milk of Magnesia or more modern MiraLAX are both popular. But when the problem is chronic constipation, many individuals don’t wish to take such products day in and day out over the long term. Are there alternatives that might be better than MiraLAX?
What Natural Alternative Might Be Better Than MiraLAX?
Q. I had a terrible bout of colitis, probably brought on by back-to-back usage of some pretty powerful antibiotics. The doctor thinks that the drugs messed up my gut bacteria.
The resulting constipation caused serious inflammation and infection. It was terribly painful and very scary, with two trips to the emergency department and a follow-up colonoscopy. Thankfully, the procedure revealed no abnormalities.
My wonderful GI doctor has recommended a daily probiotic. He also wants me to “keep the pipes open” through frequent use of MiraLAX and a fiber supplement.
The good news is the fiber supplement seems to be lowering my cholesterol for the first time in 20 years! I am concerned about the MiraLAX, though.
Is there something more natural that I can take? I like the fact that it is very effective without causing a real sense of urgency, but I worry about the unnatural ingredients.
How MiraLAX Works:
A. Your laxative contains polyethylene glycol 3350 (PEG3350), a compound which pulls fluid into the digestive tract to make stool softer and easier to pass. Japanese researchers, noting that most European studies lasted six months or less, undertook a year-long study of safety and efficacy (Journal of Gastroenterology, Sep. 2019). They found that it improved bowel function over the long term without any alarming side effects. Some people did report stomachache, nausea, diarrhea or bloating, however.
In mice, PEG3350 changes the balance of the microbiome (Journal of Pediatric Gastroenterology and Nutrition, Oct. 1, 2021). You might want to consume more foods high in fiber to encourage the repopulation of microbes in your digestive tract.
Specifically, we recommend kiwifruit. Investigators have found that it may work as well as or possibly even better than psyllium (Canadian Journal of Gastroenterology & Hepatology, Oct. 6, 2022). We have no word on whether it is better than MiraLAX. Other excellent sources of fiber include beans, greens and whole grains.
Fiber to Fight High Cholesterol:
We are not surprised to learn that your fiber supplement is helping to control your cholesterol. Soluble fiber such as that found in psyllium has documented cholesterol-lowering activity (American Journal of Clinical Nutrition, Nov. 1, 2018). In addition, psyllium husk can nudge the balance of microbes in a constipated person in a healthier direction (International Journal of Molecular Sciences, Jan. 20, 2019).
Kiwifruit and Spaghetti Squash to Fight Constipation:
Q. There is so much I cannot eat. With gluten intolerance, diabetes and gastroparesis, even the low FODMAP diet does not help much.
For me, daily kiwi and spaghetti squash help with constipation due to IBS. Do doctors know about this?
A. Your digestive difficulties certainly sound challenging. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. Doctors often recommend a low FODMAP diet for people with irritable bowel syndrome (IBS).
This diet is quite restrictive, with no dairy or wheat-based foods, beans or lentils, and limits on many fruits (apples, pears, peaches, cherries) and certain vegetables (onions, garlic, asparagus, artichokes). It should not be followed indefinitely, but used to discover which foods are most troublesome.
Fortunately, kiwi is not on the list, and neither is spaghetti squash. Both foods are also gluten-free.
Research indicates that kiwi has a beneficial effect on the gut microbiota and helps move things along the digestive tract (Food & Function, Oct. 4, 2021).
MiraLAX Can Cause Gas:
We have occasionally gotten questions about potential side effects of MiraLAX. One reader wondered about flatulence.
Q. I have a lot of gas every day. I take MiraLax every day to prevent constipation. It really works! Could it also be causing the gas?
A. MiraLAX contains polyethylene glycol 3350, classified as an osmotic laxative. If you think back to your high school science class, you may remember that osmosis is the process by which water equalizes concentrations of a solute like salt or sugar on both sides of a membrane. If you drop a raisin in a glass of water, it will plump up as water moves through the skin and into the dried grape.
The lining of the digestive tract is a semi-permeable membrane. Since polyethylene glycol is a concentrated solute that doesn’t get through the lining, water moves into the gut and softens the stool.
Miralax Side Effects:
To answer the question: Does Miralax cause gas? The answer is yes! MiraLax can cause gas and bloating. Other side include nausea, stomach cramps, diarrhea or allergic reactions such as hives, itching or trouble breathing. The label advises against continuous use for more than a week.
Learn More:
To learn more about other natural ways to keep the digestive tract functioning smoothly, you may want to read our eGuide to Controlling Constipation. You may also wish to listen to our interview with gastroenterologist Robynne Chutkan. It is Show 1115: How You Can Conquer Constipation. Many of her natural recommendations work better than MiraLAX with less likelihood of gas and other side effects.
