Bulk laxatives include psyllium (Metamucil) and. “If there’s a stricture in the bowels, it’s generally managed with medications or requires surgery to remove a part of the bowel that. Take a fiber supplement. Researchers have found that eating 3. Predisposing factors include female sex, increasing age, low socioeconomic status, depression and a history of sexual abuse. We have found Miralax to be very helpful for women that have chronic. Magnesium is also recommended for Parkies with constipation, because it also helps treat magnesium deficiency, which can cause restless legs and fidgeting. I had a bout of severe constipation and pain this afternoon. Studies have shown that constipation often begins before motor symptoms. A thing called "Rancho Recipe" given to us by mom's neurologist (prune juice, all-bran cereal and apple sauce), 200 mg. However, a person with Parkinson’s disease should consult a doctor first. (NOT RED). Children 5-12, Constipation, Toddlers 2-4. m. • Measure a capful of MiraLAX in 8 ounces of liquid, half of a capful in 4 ounces, or a teaspoon of MiraLAX in 2 ounces. I had a bout of severe constipation and pain this afternoon. Despite the significant clinical relevance of constipation, unfortunately little knowledge exists on effective treatments. Take 1 capful (17 grams) Miralax every day for 3 days in 8 oz. sensation of incomplete evacuations for at least 25% of bowel. Incorrect treatment of constipation in PD patients can result in colonic volvulus and pseudo intestinal obstruction, as well as a reduction in the therapeutic effect of anti-PD drugs due to absorption issues. Constipation affects many people with Parkinson’s disease (PD) and may be a very early symptom of the disease, sometimes beginning even before motor symptoms appear. The two contain different active ingredients: Metamucil contains psyllium fiber, while Citrucel contains methylcellulose fiber. The phenomenon I find curious is the occasional pairing of akathisia and constipation. These include polyethylene glycol (MiraLAX), milk of magnesia, magnesium citrate, lactulose, and sorbitol. increased sweating. on August 2, 2023. . Those of us who live with a chronic illness, such as Parkinson’s disease (PD), know from experience that having a sluggish bowel can be one, if not the MOST devastating,. Summary. When you move your body, the muscles in your intestines are more active, too. There’s not a known interaction between Linzess and alcohol. You’ll learn all about magnesium, the form to use to help with constipation, and the products we recommend. Fiber (Metamucil, psyllium). Hi, my husband is having a problem with constipation because of pain meds prescribed for kidney stones. Fiber supplements can effectively induce bowel movements if a low fiber diet is the cause of your constipation. Muscle problems. Lumpy or hard stools in ≥25% of defecations. Laxatives: When impacted stools are higher in the. This can help stimulate a bowel movement in some patients. In this study, the constipation group had lower MMSE scores (p < 0. This will help in treating the underlying condition better, before and relying on the most suitable treatment. Parkinson’s disease, dementia linked to. Saline enema (Fleet Enema)The Best Laxatives For Constipation. Many PD patients have been told that they can use Miralax on a daily basis if needed. May also cause increased sweating. Most people have a set bowel movement pattern. However, drinking alcohol may cause constipation or diarrhea. Surveys show that between 20% and 40% of. Laxatives can help relieve and prevent constipation. Miralax is used as a laxative to treat irregular bowel movements or constipation. He recommends picking one medication “say, an osmotic-type laxative like MiraLax “and increase the dose over a few days before switching to a different agent or strategy. g. If I don't do either Teff or Yakult, the constipation comes back. “It is gentle enough that people will do it and aggressive enough that it will work,” Dr. adults and children 17 years of age and older: use once a day. These products hold water in stool to soften it and increase bowel movements. Dulcolax is used to treat constipation or to empty the bowels before surgery, colonoscopy, x-rays, or other intestinal medical procedure. To treat chronic idiopathic constipation, the typical dosage of Linzess is 145 mcg per day. Constipation can be caused by several different reasons. nausea. Miralax helps pull water into the intestines, making it easier to pass a stool. These are fairly gentle and very popular. Use a gloved finger to check the condition of the rectum and the. As a result, it makes the stool softer and easier to pass and increases the number of bowel movements. Ignoring your body’s urges to pass stools. This results in difficult, painful, and infrequent bowel movements. shallow breathing. For WebMD, Medically Reviewed by Minesh Khatri, MD. Other laxatives may work faster, but they have more risks and side effects. Limit caffeinated beverages such as soda and coffee, which can actually leach more fluid from your body. Both are considered natural fiber types, and both options can effectively ease constipation. Soluble fiber absorbs moisture, which makes stools softer and easier to pass. dizziness. Summary. 5g/4 oz water; >12yr – 17 g/8 oz water) Maintanence. A bowel regimen is a set of medications to help people avoid or relieve constipation. I would love to hear the suggestions of others with Parkinson’s that have been successful in treating this symptom. Two 32-ounce bottles of Gatorade®. Learn about its side effects, cost, and more. Side effects may include insomnia, jitteriness and. It is one of the problems associated with PD. In her wise-mother gut, she wasn’t comfortable giving her toddler the full adult dose every day. Belching, diarrhea, cramping, nausea, changes in urine color. 49% of reviewers reported a positive effect, while 32% reported a negative effect. It is created by eHealthMe based on reports from the FDA, and is updated. Note – it may take polyethylene glycol 3350 up to 4 days to work. Side effects. e. Some children who have been constipated for a long time begin to have accidents, soiling, and poop stains in the underwear. Endocrine dysfunction An endocrine disorder is when there’s an issue with one or more of your hormones. A child will not become dependent on Miralax by using it. Abnormal behavior in the litter box (crying, digging, uncleanliness) Loss of appetite. Tender Meat – Full of protein and fat but lacking in fiber, that juicy steak needs to be balanced with a side of broccoli. These can include: Not consuming enough fiber and fluids. 00 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This medicine is in a class of drugs called osmotic laxatives. Certain flavors may only be available in name brands. Osmotic laxatives are available as liquids, suppositories, and powders that you mix into a beverage. Parkinson’s disease. Start by taking 2 tablets at bedtime, if you do not have a comfortable bowel movement (BM) the next day, take 4 tablets the next night. Screen for warning signs of malignancy or IBD: bleeding, weight loss, change in stool caliber, new constipation, fevers, anorexia, family history of colon cancer or IBD. Lack of fiber. Important tip: All of these medications come in generic brands. This means that chronic constipation is a frequent problem and needs to be addressed when caring for patients with dementia. Infrequent bowel movements are a common cause of hard stools. Another option that works for some people is diet candies. This finding indicates that. ), exercise regularly at a slow, steady pace, as directed by md if you are able. The. These beneficial effects are due to their high content of fiber, phenolic compounds and sorbitol. MiraLax (polyethylene glycol 3350) is a good substitute. This is not a complete list of side effects and others may occur. 5 g/kg daily (initial dose 0. If laxatives don't work, ask for help. You may have diarrhea, which can look stringy. Patients should be referred to a physician in the following situations (among others): 1) the patient has a serious underlying medical condition (e. Vomiting. Give at 8 a. Anal strictures are typically the cause of constipation. As we age, we lose muscle mass, and this can affect gut motility and contribute to constipation in older adults. Common hormone disorders that can cause constipation include:Chronic constipation is defined by Rome III criteria2: Presence of 2 or more of the following symptoms: Straining during ≥25% of defecations. Your child’s Miralax dose is: 8 capfuls of Miralax powder in 32 to 64 ounces of liquid OR . One of the most common laxatives doctors use to treat chronic constipation, such as that in people with Parkinson’s disease, is polyethylene glycol, an osmotic. SN instructed patient and caregiver on measures to prevent constipation: increasing fluids (prefer approx. For colonoscopy prep, the super high dose works great. Unlike some laxatives which stimulate the nerves, MiraLAX is a non stimulant osmotic laxative, working naturally with the water in your body to hydrate, soften, and ease stool through the colon gently. Wael El-Nachef. I have an appt with the dr to try and get a Rx to help. 4/5. Official answer. ClearLax has an average rating of 9. My husbands dose of C/L was increased to help tremors and stiffness. There may be something more serious going on, like a blockage in. Updated on February 27, 2022. Pour the fine, white powder into the cap until it fills the white section of the cap’s underside. travel. A similar study investigating constipation reported a prevalence of 24. It is generally safe for patients with chronic kidney disease . Zoppi et al. If you're taking aloe and your constipation lasts longer than a week, talk to your doctor or try a different remedy. You know, that plugged up feeling you get in which you have to poop but you can’t. This is the American ICD-10-CM version of K59. In severe. Symptoms develop slowly and the progression varies from person to person. Parkinson’s disease. Miralax works better than Colace for constipation caused by medications. Larger numbers of people with PD have related gastrointestinal issues such as bloating, a feeling of fullness and nausea. Other laxatives may work faster, but they have more risks and side effects. stress. Gently Unblocks Your Gut. Never exceed 3/4 teaspoon of Miralax for every 10 pounds of the dog’s body weight over a 24-hour period. Although constipation is not a physiologic consequence of normal aging, decreased mobility, medications, underlying diseases, and rectal sensory-motor dysfunction may. Gently tap or shake the cap in order to level out the powder and make sure it’s at the 17-gram line. For occasional mild constipation this stuff works great. Do not use aloe to treat constipation for more than 1 week. Common MiraLAX side effects may include: bloating, gas, upset stomach; dizziness; or. , Citrucel, Metamucil) are contraindicated if the patient. ] June 15, 2013 in Other. What Is IBS With Alternating Constipation and Diarrhea? One condition for which constipation and diarrhea are characteristic is mixed-type irritable bowel syndrome (IBS-M). Miralax is used as a laxative to treat irregular bowel movements or constipation. Polyethylene glycol 3350 is a product used to treat occasional constipation or irregular bowel movements. 1. Constipation . Miralax is best used for occasional constipation, while Senna is used for short-term relief of constipation. Among the non-motor symptoms of PD are cognitive changes, constipation, sleep issues and mood disorders. Both are considered natural fiber types, and both options can effectively ease constipation. What causes constipation?Miralax is a common prescription and over-the-counter drug that is used for the treatment of occasional constipation. . D. com. The purpose of this section is to help the learner understand Parkinson’s disease and what to consider . If Miralax doesn’t work after a week or so, contact your healthcare provider. Also, a reduction in dairy products tends to decrease heartburn. Miralax typically works within 1 to 3 days. Vanessa Nunes/iStock. Purchase: Four Dulcolax® laxative tablets containing 5mg of bisacodyl each (NOT Dulcolax stool softener). Stool history: frequency. Miralax is an osmotic laxative that contains polyethylene glycol. Over the years we have noticed that Parkinson’s disease patients commonly present with constipation. The symptoms of neurogenic bowel dysfunction (NBD) comprise constipation and fecal incontinence. Parkinson’s disease. Constipation often increases as Parkinson’s progresses. Parkinson’s disease, multiple sclerosis. gas and bloating. This medicine is in a class of drugs called osmotic laxatives. Miralax The active ingredient is polyethylene glycol, which pulls water into the stool to help relieve constipation. Too much fiber without adequate water intake can also cause or worsen constipation. Dr. Hypothyroidism. Purchase: Four Dulcolax® laxative tablets containing 5mg of bisacodyl each (NOT Dulcolax stool softener). Common GI disturbances in patients with PD include gastroparesis (GP), constipation and small intestinal bacterial overgrowth syndrome (SIBO). Constipation is a commonly experienced side effect during cancer treatment and may occur due to various reasons, one of which is the chemotherapy itself. But, in 2017, some families. Increase in Carbidopa/levodopa causing constipation. This medicine is in a class of drugs called osmotic laxatives. Dulcolax and Miralax are two popular, FDA approved over-the-counter laxatives used to treat occasional constipation and irregularity. Identifying these signs and symptoms is critical to develop an accurate nursing diagnosis for constipation and design effective nursing care plans to address patient needs. Dulcolax is a stimulant laxative that increases intestinal activity to cause a bowel movement. Prior to starting the Miralax regimen, my daughter would suffer from daily stomach pain. Insoluble fiber, which is primarily found in fruits and vegetables, makes stools softer and bulks them up. other medications, such as iron. use equipment such as an anoscope — to see inside the rectum — and suction, if necessary. Miralax Dose Mix with Clear Liquid Polyethylene glycol (Miralax, Glycolax or PEG) 1 Capful = 17 grams. diarrhea with dizziness or a light-headed feeling (like you might pass out). Many of us mistakenly drink milk when our stomachs are burning; however, this causes an increase in acid production to break down the dairy. Fiber truly is your best friend—even if it comes in powder form. Chronic constipation refers to these symptoms when they last for several weeks or longer. Metamucil is a bulk-forming laxative that contains psyllium, a soluble fiber. It has a sugar and non-sugar option. The trick with taking these laxatives is to take them regularly rather than when you need them. of juice 3 to <6 years old 3 day oral disimpaction: After 3 day cleanout: On day 4 take ½ capful (8. Constipation also occurs when your poop appears hard, dry and pebble-like, or if you experience straining, incomplete evacuation or difficulty passing stool. There are 71,894 people reported to have side effects when taking Miralax. Many different hormones help to regulate the bowels. But not all laxatives are safe for long-term use. PEG is a well-established treatment of constipation in children. I feel like the constipation is affecting the weight loss. stir and dissolve one packet of powder (17 g) in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink. 5-2. , phosphate binders), and multiple comorbidities (e. 1,2 Thus, prucalopride provided clinicians with an option that could help treat conventional laxative refractory. MiraLax: Gentle and well-tolerated by people with Parkinson's. If your symptoms aren’t severe or you have side. * See the “ MiraLAX: How to take ” section below for information on preparing the liquid solution. Start by taking 2 tablets at bedtime, if you do not have a comfortable bowel movement (BM) the next day, take 4 tablets the next night. Constipation is one of the most common gastrointestinal disorders among patients with chronic kidney disease (CKD) partly because of their sedentary lifestyle, low fiber and fluid intake, concomitant medications (e. Key takeaways: Miralax (polyethylene glycol 3350) and Colace (docusate) are both over-the-counter medications for constipation. These are signs of months or years of constipation. Consider these natural tablets for continuous relief without the fear of negative side effects. In January of this year the FDA announced it would fund research into the safety of the very popular constipation medication Miralax. You can continue to increase the dose by 2 tablets every night until it works. In an opinion (PDF) issued on August. Mix 2 teaspoons of Miralax in their food or drink 1-2x/day for 2-4 weeks If the patient is doing well, stay on this dose; If there is diarrhea then decrease each dose by ¼ to ½ tspn per dose; If there is still constipation then increase each dose by ¼ to ½ tspn per doseMiralax works by way of osmosis, a term that means water movement from one membrane to another. Domperidone is to be given only by or under the immediate supervision of your doctor. Constipation has Organic Causes (it all isn’t just Functional Constipation) Although ~95% of constipation is functional… you don’t get paid for the 95% diagnosis (Grandma can make that call)… you get paid to not miss the other 5%. -Advise the patient to mix 3-4 17g doses of. Walking is a good exercise to prevent or relieve constipation. Eating large amounts of dairy products. Common interactions include anxiety among females, and depression among males. Fiber by Diet: Increase daily intake of raw vegetables and fruits. Dulcolax is a laxative that stimulates bowel movements. A. Lack of energy. The microbiome is the community of bacteria, viruses, and fungi that live in the digestive system. Sensation of anorectal obstruction/blockage for ≥25% of defecations. It works naturally with the water in your body to unblock your system without harsh side effects. PD can cause. gut bugs) that aid in digestion and intestinal motility. 3-ounce bottle of MiraLAX® (238 grams) or generic equivalent. gas and bloating. Drink only clear liquids. Flax Seed Meal – add a tablespoon to yogurt, hot cereal, or breads. g. Miralax vs. Increasing activity and exercise can also improve constipation. 5% in those aged over 60 years [], with a higher susceptibility in females and individuals under a low socioeconomic status [1, 2]. Please Don't Use Miralax For Constipation Please Don't Use Miralax For Constipation. If stool softeners aren't providing enough help, the osmotic laxative polyethylene glycol (MiraLAX or a generic version) is good next step. Insoluble fiber, which is primarily found in fruits and vegetables, makes stools softer and bulks them up. Flax seed, and flax seed oil, olive oil, prune juice, prune juice based anti-constipation cocktails, otc. (PEG). Medicines used to treat Parkinson’s disease. Colace for Constipation: 5 Key. ②Polyethylene glycol (PEG) 3350, the active ingredient in MiraLAX, has been safely and effectively used in adults for years to provide constipation relief, and healthcare professionals have. Dulcolax and Miralax are both OTC laxatives used to treat constipation. If you are taking a prescription medication, ask your doctor if you can take milk of magnesia. Stimulates intestinal muscles to help stool move more quickly. Constipation of varying degrees is common, however most people are not as bad as your recent experience, needing to go to ER. I say 'feel' beause to me if you've. By Patrick McNamara, PhD. an irregular heartbeat. It works naturally with the water in your body to unblock your system without harsh side effects. Drug interactions are reported among 74 people who take Psyllium husk and Miralax. But when you have constipation, the best laxative is the gentlest and safest option, like a bulk-forming laxative. It’s shown some promise in kids with constipation and in adults with Parkinson’s disease (10, 11). Common side effects include GI symptoms, headache, fatigue, and dizziness. It now states grams (g) instead of milligrams (mg). Key takeaways: Miralax (polyethylene glycol 3350) is a laxative that helps relieve constipation. Many different hormones help to regulate the bowels. Parkinson’s Disease: Combating Constipation (Part 2) Caffeine (a cup of coffee, for example). Miralax, a polyethylene glycol laxative, is available over-the-counter and in generic form. In industrialized nations, people are overwhelmingly deficient in magnesium. It has a sugar and non-sugar option. Metamucil (psyllium fiber) is contraindicated (i. This is not a complete list of side effects and others may occur. The emergency vet I went to also mentioned that too much fiber can cause more constipation, but he said that for an 10-11 pound cat, 1 teaspoon of pumpkin daily should be okay. Search the Healthwise Knowledgebase . Constipation often increases as Parkinson’s progresses; Constipation is a direct symptom of Parkinson’s because of damage that is caused to the nerves that line the gut. Overnight Relief. Mix it well and Drink this homemade laxative baking soda for constipation twice a day. stimulant laxatives. The more time. As it is not a fiber supplement, Miralax does not offer the same additional. Linaclotide (Linzess) and. Frequency: once per day. Everyone is different. 0. Constipation can significantly decrease quality of life, causing abdominal discomfort, a loss of appetite, bloating, and, if not corrected, can even lead to serious Background Constipation is one of the most common non-motor symptoms in PD patients, and the constipation, can appear before motor symptoms. Beans, especially black beans – add to burgers, rice, or soup. changes in your routine. I like how gentle this product is and it doesn't cause cramps or excessive gas/bloating. Common Linzess side effects may include: diarrhea; stomach pain; gas; or. Hard, dry or lumpy stools. Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis. Myth. Straining or pain when passing stools. The maximum dose of MiraLAX is 17 gm (one heaping tablespoon) in 220 mL of clear liquid every 10 minutes until 2000 mL of volume is consumed. neurologic disorders such as Parkinson's disease, multiple sclerosis, or spinal cord injury;Constipation and Urologic Problems In order to understand constipation, one must first understand normal bowel function. stir and dissolve one packet of powder (17 g) in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink. Your stool may look smaller or narrower than normal. Lack of physical activity. Different types of treatment are used when treating. The blessing of Parkinson’s disease is we don’t have to deal with the trots or the squirts as others do. Some non-motor symptoms may improve with an adjustment to your. Miralax is prescribed for bowel preparation, acute constipation, and constipation. You can continue to increase the dose by 2 tablets every night until it works. Adequate water intake is also key for ensuring the fiber is passable and for preventing dehydration. In this blog post, we will discuss the benefits of Miralax for dogs and how to administer it correctly. * See the “ MiraLAX: How to take ” section below for information on preparing the liquid solution. I'm a 21 year old South Asian female and I have been having GI issues for about five years–mainly along the lines of constipation. Parkinson’s disease. Laxative abuse. Senna is a natural plant product. Although the FDA has not approved PEG 3350 for use in. Stool softeners, such as Colace (docusate), can be used if stools are hard. John. The more common side effects of Amitiza can include: headache. The USDA recommends 25 grams for women and 38 grams for. Six to eight 8-ounce glasses of water daily are recommended. Constipation may last from a few days to several weeks. Stress, depression or. Drugs are a commonly overlooked cause of constipation. Causes for ConstipationMiraLax, or polyethylene glycol, is an osmotic laxative, which means it draws water into the intestine and softens the stool. Other treatment options for constipation with back pain. One of the reasons for this is that there is no standard way to prepare or prescribe prune juice. Try an omelet with fresh spinach and tomatoes. Moreover, it helps to maintain a healthy digestive system and promotes regularity. This can help when the impaction is not as close to the anus. 1 out of 10 from a total of 253 ratings on Drugs. Additionally, this section will review accommodations an adult foster home provider needs to make when caring for a resident with Parkinson’s disease. k. Increase fiber intake: Add more high-fiber foods – such as prunes, beans and bran cereal – to your diet for a natural laxative option. Digital disimpaction: A healthcare provider dislodges hardened stool with a gloved, lubricated finger. Among the non-motor symptoms of PD are cognitive changes, constipation, sleep issues and mood disorders. Or at least, try to help relieve your cat’s symptoms. 00 - other international versions of ICD-10 K59. The Bristol Stool Form Scale (BSFS) reflects the time it takes for food to pass through your intestine. Of the total drug interactions, 214 are moderate, and 1 is minor. Postoperative ileus is an abnormal pattern of slow or absent gastrointestinal motility in response to surgical procedures. If you take more than the recommended dose, it tends to work much better, but also can cause nausea and cramping. 78g/kg/Day; 2-11yr – 8. Motegrity (prucalopride) was approved by the FDA in 2018 for functional constipation (chronic idiopathic constipation) in adults. We get to deal with that other word we don’t want to talk about: constipation . The phase IV clinical study analyzes what interactions people who take Psyllium husk and Miralax have. g. Consuming more fruits and vegetables, as well as plenty of water, can help prevent constipation in people with Parkinson's disease. Expensive. • Age 1 year and older: o Give Miralax powder with a typical starting dose of ½ capful up to a typical maximum dose up to 1 capful per day . It contains a natural plant fiber called psyllium husk and, in addition to the powdered form, comes as cookies, tablets and gummies. 2 Additionally, these products are often added to stimulant laxatives to treat constipation. MiraLAX may not be right for people with certain medical conditions such as irritable bowel syndrome, bowel obstruction, and kidney disease. 1 out of 10 from a total of 253 ratings on Drugs. Overuse of certain laxatives may lead to dependency and decreased bowel function. Buy your bowel preparation at least five days before your colonoscopy. Constipation and the Gut in Parkinson's. Bowel symptoms occur in the majority of patients with chronic neurological diseases like multiple sclerosis, spinal cord injury, and Parkinson's. When bowel movements become less frequent, you may begin to feel constipated. Domperidone is a medicine that increases the movements or contractions of the stomach and bowel. Lowering medications that may have anticholinergic side effects may be necessary. ClearLax for Constipation User Reviews. Soluble fiber will dissolve into a. Dulcolax suppositories generally produces bowel movements in 15 minutes to. Among the non-motor symptoms of PD are cognitive changes, constipation, sleep issues and mood disorders. Miralax is a stool softener, while Senna is a stimulant laxative. Another laxative that can be used for chronic constipation is lubiprostone (Amitiza), which also appears helpful for treating constipation in those with Lewy disorders; it requires a prescription. Mild side effects* of MiraLAX may include: diarrhea or stools that are watery, loose, or more frequent than usual. Stool softeners are considered safe during. 1. 5 ounces of prunes daily for three weeks may improve stool consistency and increase the frequency of bowel movements. Difficulty swallowing, feelings of nausea and constipation are all common symptoms of Parkinson’s disease (PD). 8 glasses of water daily) eating a diet high in fiber, and avoiding foods with sugars (pasta, pastries, cheese, rice, etc. blood in your stools; or. Occasional irregularity is a fact of life, but you can minimize it with some basic steps. Parkinson's Resource Organization 74785. K59. So having too much or too little of a hormone can lead to constipation. So, the non-response to MiraLax for 3 days or more may. Managing constipation can be done through dietary changes, increased fluid intake, and medications. Surveys show that between 20% and 40% of people with Parkinson's disease (PD) suffer from serious constipation (fewer than three bowel movements per week). The maximum dose that’s recommended is 145 mcg. nausea. Infrequent passage of stool- fewer than three bowel movements per week. Some non-motor symptoms may improve with an adjustment to your Parkinson's medication. Taking bulk fiber, or things like MiraLAX just makes it worse because I don’t get an urge to go and everything just seems to get stuck—for lack of a better way to describe it.