When to take miralax?

I had to do 3 things to get my intestinal track right. Note that you can buy these products off the internet. Just google them or try amazon or some really good natural foods markets.
First, I started taking this particular intestinal flora. I tried other flora brands and none had an impact like this brand. Actually i can’t really say I had ANY impact at all using any other brand of typically lesser strength.
I started off with this 200 billion version for 1 week. The box contains only 7 packets, which you take 1 a day mixed with any liquid.

Then switched to 2 pills a day of this one for “maintenance”. I took both of these intestinal flora packets and pills on an empty stomach right when I first wake up (not sure when is optimal, but that worked for me).

Then I added 1 heaping tsp of this (mixed with herb tea) to my diet in the morning, right after breakfast. I used to take this daily, but stopped when I started the IP diet. Yes, there is a tiny amount of carbs in this (5g and 20cals) but it has so much soluble and insoluble fiber, that the blood sugar impact is negligible …

Finally, I had to stop eating the IP Broccoli Cheese Soup, which had a tiny bit of soy in it (way down on the ingredients list). For some reason the soy that IP uses doesnt play well with my intestines. It’s interesting that there is “soy fiber” (non GMO) in the colon cleanser product above, but that hasn’t had any adverse effect on me in 30+ years. So I guess for me at least, soy fiber is OK but soy protein is bad news. In any case, the only IP products that I eat now are whey-based and contain no soy (which for me right now is the Chocolate Drink Mix only). So if you have any food allergies, check the ingredients list. I think a lot of people have a hard time digesting certain elements of soy (me included).
It’s amazing how far I have come in the 2 weeks since I started this regimen. My bowel movements are so clean (no smell) and easy (no strain) and regular (2x a day) and complete now that I don’t need toilet paper afterwards. And I feel extremely (incredibly, amazingly) clean internally. This has been a big wow for me.
Previous to this system, I was constipated all the time, always felt like I had to go, but couldn’t. And my bowel movements were the consistency of sticky glue that seemed to stick to my intestinal walls.
Doing this new system has definitely helped me break free from a plateau that I was in in the low 270’s too. So I am actually losing weight better now that my intestines are working at peak efficiency.
So some of this is experimenting to find what works optimally with your body and sensitivities.

This Is What It’s Like Being Addicted to Laxatives

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This post originally appeared on VICE UK.

Shit is a fact of life. It’s also a good litmus test for the wellbeing of our body’s inner mechanisms. Regular, firm, a decent colour? You’re doing okay. Black and tar-like? Something’s probably up. Haven’t dropped your kids off at the pool in days? Eat a banana, or head to the pharmacy.

Laxatives are a valuable tool for the constipation afflicted, but they can also disguise a toxic secret. For those with eating disorders, laxatives can become a crutch, an addiction, a weapon against their own bodies.

Anorexia and bulimia are, like many other mental health conditions, difficult to talk about. They’re wrapped in shame, stigma and the fear of being viewed differently. But what we hear or talk about even less are the men and women bent double over the toilet having abused laxatives to the point of acute pain, purging their colon in pursuit of thinness. There are no exact stats on how many people this includes in the UK, but it has been found that most people who suffer from an eating disorder have used laxatives at some time.

For six months of my life, I was one of these people.

Having danced with anorexia for much of my early adolescence, I first discovered Dulcolax laxatives at the age of 16.

It was Christmas, the time where everyone worships at the altar of overeating, I hadn’t taken a shit in maybe three days, which made me anxious to the point of losing my sleep. However hard I tried to claw the food from inside my stomach via the throat – scratching at my tonsils in the vain hope of vomiting – nothing came up. So I begged my dad to go to the pharmacy and pick something up that would help me go. And it did. A lot. Needless to say, I was hooked, and when I ran out of the stash in my parent’s cupboard, I bought my own laxatives and took them every day for the six months.

During that time, I shat myself more times than I can count. I left toilets in the state of a nuclear wasteland. My stomach was apocalyptic. The cramps were devastating. I thought up dozens of excuses to sneak off and crouch on the toilet to let the rusty liquid fall from my arse. There was sweating, god-awful wind and the never-ending knowledge that I was filled with a “poison” that needed to come out.

READ: Prescription Drugs Are Quietly Killing My Generation

I bought laxatives wherever I could: Boots, supermarkets, Poundland – they’re readily available over the counter and carry no age limit to buy. The little yellow pills would be stashed in my wallet, or in a hole I had cut in the mattress. I counted them out on the desk in my Spanish class – I timed it perfectly, taking them ten hours before I wanted to go to the toilet, so they’d kick in in the middle of the night when nobody would hear me.

Eventually, though, my parents found out; at some point my mum realised she’d been routinely scouring a horrific toilet that didn’t seem to get clean for six months. The gig was up. Truthfully, I was relieved. My parents were magnificent and helped me through therapy and back on my feet. Today, I am not dependant on laxatives.

So, from my current vantage point, I find myself asking: what was the point? Where did it come from? Why do people with eating disorders become addicted to laxatives?

Personally, I took them because I thought it was an effective purging method, that I was “clearing out” the calories before my body had the chance to absorb them, that I was absolving myself of any fat I’d consumed and avoiding dreaded weight gain. The feeling of emptiness was addictive. It started to feel necessary. I was scared not to take my trusted pills out with me in case my body clung on to what I ate. Thinking back, though, I guess the reasons were much more complex.

A medical study in the US looked at laxative abuse as a form of self-punishment, and concluded that “the self-harm and potentially anxiolytic features should not be overlooked.” The abuse of laxatives can certainly neutralise the fear of weight gain and, for many – including me – the physical factors constitute a form of self-harm.

The sad truth is that, however empty or “safe” a large dose of laxatives might make you feel, their function in weight loss is largely redundant. By the time any food has reached your large intestine – where laxatives act – most calories have been absorbed by the body. What you’re purging is just water, electrolytes, minerals and a load of other faecal waste.

Caitlin*, who started taking laxatives while discovering them working in a pharmacy, but has since quit, and now sees the futility in taking them. “Laxatives give you a false sense of security. You think you’re losing weight, when all that’s happening is you are losing water from your system and crucially it affects the balance of electrolytes which impacts your heart. Laxatives don’t make you lose weight at all.”

There’s also the problem of tolerance that comes into play, too. The chronic laxative abuser risks damaging the natural cycle of their colon to the point where they cannot defecate without a large dosage of laxatives. Jordan, aged 25, believes laxative abuse has had a hugely adverse effect on her health. “I have a lot of problems with my digestive system and have to take medication to allow me to use the toilet,” she says. “This is something from which I’ll likely never recover.”

The dehydration that comes with abusing laxatives can also really fuck over your organs – the loss of vital minerals such as potassium puts a huge strain on your heart, nerves and colon. Sometimes this results in hospitalisation. “Due to my laxative abuse,” one girl told BBC’s Watchdog, “I stripped the inside of my stomach lining. I was sent to A&E numerous times with stomach spasms and bad cramps.” Now, her bowels have become lazy. As with dependence on any drug, your body sort of forgets how to function without it.

The problem is, laxatives – which, lets not make any bones about it, are powerful drugs – are incredibly easy to procure. Should pharmacists deny or at least question a girl in a school uniform if she’s buying Senokot? Even if she says it’s for her dad? Maybe. I was only ever questioned once: the cashier asked her manager who denied me the sale. I remember my face turning beetroot, anxiety throttling my already empty stomach as I shuffled out of the shop. Only, I was less embarrassed and more bothered that I would have to go somewhere else to get my fix.

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Lindsay, aged 20, abused laxatives for seven years. She recently saw that Boots now sell the pills at 100 per packet. “Honestly, it just makes it easier,” she says, explaining that supermarket cashiers are blind to the problem. “Nobody ever questioned or challenged me when I bought a number of packets,” says Rebecca. From my perspective, Boots selling laxatives by the hundred raises alarm bells. It makes it far easier for those with eating disorders to endanger themselves.

So, what can actually be done?

B-eat UK, the leading national charity for eating disorders, is calling for tighter restrictions on the sale of laxatives in the UK. Specifically, they want a minimum age of 16, a maximum pack size, a strict behind-the-counter regulation and labels on packets that say, clearly: “This is not a weight loss product.” But supermarkets and pharmacies have remained pretty silent on the matter. It’s a shame, because restricting access might go some way to prevent the health ramifications that are a by-product of abuse.

It feels like laxative abuse is one of the last hurdles in our wider discussions about eating disorders – because, frankly, people still hold all sorts of prejudices over talking about shit. Despite the prevalence of this manifestation of eating disorders, we’re still far more likely to see or hear the story of a girl or boy who had starved their way down to five stone. We’re still profoundly shocked by images of skeletal, profoundly unwell young people with their ribs and clavicles almost piercing their paper-y skin, but we’re almost used to seeing them. That’s what we associate with the term “eating disorder”.

But just because someone abusing laxatives doesn’t fit this image (at the height of my laxative abuse, I was very thin, but not thin enough to shock like those images do), it doesn’t mean they’re not stuck in a similar cycle of abuse, physical pain, loneliness and psychological distress. With upwards of 1.5 million people in the UK thought to be suffering from an eating disorder, and a large proportion of those people likely to be abusing laxatives, it’s something we need to stop sweeping under the carpet.

*Names have been changed
If you are concerned about the mental health of you or someone you know, talk to Mind on 020 22 00 60 or at their website, here.

More stuff like this:

Why It’s So Hard To Talk About Male Anorexia

My Eating Disorder Had Nothing to Do with Barbie or the Media

Over-the-Counter Options

If you’re still constipated after making lifestyle changes, your doctor may suggest some other remedies:

Laxatives help to empty your bowels. Although laxatives are available over the counter, you should use them as directed by your doctor because your body can get dependent on them. Also, overusing laxatives can cause diarrhea.

Laxatives come in liquid, tablet, gum, capsule, granule, or powder forms.

Fiber supplements make your stool bulkier so it’s easier to pass. Be aware that these supplements can also cause bloating. Examples include psyllium (Metamucil, Konsyl), calcium polycarbophil (FiberCon), methylcellulose fiber (Citrucel).

Osmotic agents help your stool retain fluid so it’s easier for it to pass out of your body. These drugs can cause dehydration or mineral imbalance, and should be taken with caution by people who are older, or have heart or kidney failure. Examples include oral magnesium hydroxide (Phillips’ Milk of Magnesia), magnesium citrate, lactulose (Kristalose), and polyethylene glycol (Miralax).

Stool softeners keep the stool soft by drawing water from the intestines. Doctors usually suggest stool softeners for people who shouldn’t strain while using the bathroom, especially if you’ve just had surgery or given birth. Examples include docusate sodium (Colace) and docusate calcium (Surfak).

Lubricants coat the stool, making it easier for it to pass through. These may be suggested for people with blockage in the anus or rectum.

Stimulant laxatives cause the intestine to contract, moving the stool. Your doctor may recommend these if your constipation is severe and other treatments haven’t worked. They can cause side effects such as low potassium levels. Examples include senna (Senokot, Ex-Lax) and bisacodyl (Correctol, Dulcolax, Dacodyl).

Suppositories and enemas are laxatives that you put into your rectum, such as soapsuds, tap water, or enema kits that contain sodium phosphate/biphosphate (Fleet). Although they work faster than oral drugs, most people don’t like using them. Fleet enemas are not advised if you have heart or kidney problems.

Your doctor will likely advise you to stop taking laxatives once your stools are soft and you’re able to go to the bathroom easily.

We all have those days when it’s so tough to have a bowel movement that even the throes of childbirth look like a cakewalk. In fact, it happens more often than you think: According to the Women’s Health Foundation, more than 4 million Americans suffer from frequent constipation. And as luck would have it, women are three times more likely to get blocked up than men. Some doctors speculate it’s because our colons are slightly longer, adding more twists and turns—and potential roadblocks—to our digestive tracts.

But while the bloating and abdominal pain associated with a gridlocked gut may be common, the symptoms aren’t something you should simply flush down the drain. “Very severe constipation is not only very uncomfortable, but it can also lead to blockage of your colon (obstipation), which then may require more invasive treatment than laxatives alone,” says Lee Ann Chen, M.D., a gastroenterologist at NYU Langone Medical Center. Translation: The last thing you want to do when there’s a kink in your pipes is partake in anything that might plug you up even more. To help move things along when you just can’t go, make it a point to avoid these poop-blocking behaviors:

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If you want your inner plumbing to flow smoothly, you have to feed it the right type of food. It’s no secret that processed foods are high in fat, which slows down digestion and contributes to constipation. But, according to Toyia James-Stevenson, M.D., a gastroenterologist at Indiana University Health, they’re also loaded with fructans—carbohydrates that improve the shelf life of packaged foods but destroy our natural digestive processes. That’s because our intestines don’t have the enzymes that are necessary to properly break them down. “Fructans are found in several common foods like breads, pastas, and crackers,” she says, “and they have been linked to causing GI symptoms like bloating, constipation, diarrhea and gas.”

Rather than cracking open a bag of who-knows-what’s-in-these chips, set your sights on gastro-friendly grub that’s high in fiber and comes straight from the earth. These include fruits, vegetables, beans, nuts, brown rice, wheat, and oats. “I tell my patients to aim for 25 to 30 grams of fiber a day,” says Theodore Sy, M.D., board-certified gastroenterologist at Saddleback Memorial Medical Center in Laguna Hills, Calif. “Fiber can sometimes cause bloating and gas, so it is wise to slowly increase the amount in your diet until you reach the recommended amount.”

Related: 7 Totally Not-Dumb Poop Questions You’ve Been Too Embarrassed to Ask

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While you might need an early-morning coffee fix or a nightly wine-and-dine for your sanity, swigging excess caffeine and alcohol could rob your body of the hydration it needs to have a proper bowel movement. “Drinking alcohol inhibits anti-diuretic hormone (ADH), and in doing this it causes diuresis, or urination,” says Bhavesh Shah, M.D., medical director of interventional gastroenterology at Memorial Medical Center in Long Beach. “More diuresis can lead to dehydration, which can make the symptoms of constipation worse. Likewise, caffeine is a stimulant that can cause the opposite effect of diarrhea in some individuals.”

Water might not exactly be a beverage that’ll turn your mood around on a dime, but it’s the best thing to pour in your glass when you’re feeling stopped up. “Adequate daily fluid intake is essential, and the average healthy woman should try to consume at least 91 ounces of water daily,” says James-Stevenson. If you like to have options in terms of flavor, prune juice is the go-to alternative to the clear stuff for constipation relief.

This easy water bottle hack will help you stay properly hydrated every single day:

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Trying to pass gas through an already backed-up colon isn’t exactly a thrill ride. Actually, it can be downright painful. And since milky products are notorious for making you feel bloated when they’re consumed, you’ll avoid a whole lot of discomfort if you just say no to dairy when you’re having trouble going No. 2. “These symptoms are due to deficiency of the enzyme lactase in the gut needed to break down dairy into simple sugars that are absorbed by the small intestines,” says James-Stevenson. “Dairy products that are high in lactose include cow’s milk, ice cream, creams, and processed cheeses (like American and cottage cheese).”

For those of us who can’t get by without our Greek yogurt, the good news is that not all dairy has to be off-limits: “Good alternatives with lower amounts of lactose include lactose-free milk; sherbets; ‘hard’ cheeses, like Swiss, parmesan and blue; and yogurt,” says James-Stevenson.

Related: 8 Foods to Eat Tonight to De-Bloat by Tomorrow

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If you’ve ever gotten the runs while running, you know that exercise has a regulating effect on the body. Inactivity does the complete opposite: “A low level of physical activity is a major risk factor for constipation,” says James-Stevenson. “This is likely related to decreased gut movement and less blood flow to the gut.” So if your pooping schedule isn’t quite up to par, skipping out on your fitness routine isn’t going to make your situation any better.

“Exercise increases blood flow to the vital organs of the body, including the digestive tract, and increases your metabolism,” says Shah. Any type of exercise is helpful in combatting constipation—including walking, running, biking, swimming, yoga, and more—so pick your favorite and go nuts. (The Slim, Sexy, Strong Workout DVD is the fast, flexible workout you’ve been waiting for!)

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“Iron and calcium supplements can cause constipation, as they can both slow down the contractions of the GI system,” says Joann Kwah, M.D., attending gastroenterologist and assistant professor of medicine at Montefiore Medical Center in New York. But proceed with caution: These vitamins are typically recommended by doctors if you have a specific deficiency. So if you have a medical condition that requires you to take them and the side effects are kicking you right in the gut, you can always ask your physician for alternative options (like eating more of these foods high in iron).

“It may be that you need a laxative to help you tolerate these side effects, or perhaps the dose or formulation of these supplements can be adjusted to improve their tolerability,” says Chen. “Sometimes minor lifestyle changes are sufficient to overcome the constipation. Each case is different.” If you’re taking the supplements simply as a preventive measure and not for a medical reason, then it should be safe to ease up on your dosage. But when in doubt, always talk to your doc first.

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If you’re taking over-the-counter painkillers on the daily and the struggle of going to the bathroom is oh-so real, then you might want to take a second look at what’s in your medicine cabinet. “Several medications can contribute to constipation, including over-the-counter and prescription NSAID pain relievers such as ibuprofen and naproxen,” says James-Stevenson.

This one’s an easy fix: Discontinuing meds like Motrin and Aleve and making the switch to acetaminophen should help unclog your pipes. But again, always consult with your doctor before making any big decisions—especially if you’re on a strict course of medication prescribed by your doctor for a preexisting condition.

Related: 6 Secrets of People Who Poop Perfectly

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Pharmacy shelves are packed to the gills with different types of laxatives. At first glance, they might seem like the magic wand you need to make your poop-less bathroom visits disappear. But not all of these meds are created equal, and depending on them too much for relief can do more harm than good. “Your body can get used to relying on stimulant laxatives, like Dulcolax and Senna, in order to have a bowel movement if these types of laxatives are used on a long-term basis, as your colon can lose the ability to contract on its own,” says Shah. This is just one of a host of side effects associated with prolonged laxative use, which include electrolyte imbalances, seizures, heart arrhythmias, muscle aches, and more.

To be on the safe side, follow the dosing instructions on the box, and don’t use any type of laxative for more than a week or two without telling your doctor first. They might recommend that you take a different type of laxative (like an osmotic laxative, such as Miralax) or fiber-bulking agents (like Metamucil or Citrucel) instead. According to James-Stevenson, these are “considered safe for short- and long-term treatment of constipation symptoms.” Regular probiotic use can safely stave off difficult dumps, too. (Here are the best probiotics for your health.)

If altering your diet or activity isn’t solving your poop problems at the end of the day, don’t wave it off: “A change in your bowel habits can sometimes be a sign of something more ominous occurring with your health, such as colorectal cancer,” says Chen. “If you notice a consistent change, inform your doctor.”

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