My 12 year old went to our pediatrician 3 times last summer and the doc recommended more liquids, Miralax, Prilosec, cutting out milk, etc. Nothing seemed to help much, she still just pooped a few bunny pellets, had nausea and cramps. Then we went to a pediatric Gastro Intestinal doctor who took a photo and found that he whole large intestine (from small intestine to colon) was full and compacted!!
This is the clean out regimen the GI recommended, which we followed and now she feels great (copied from the take home instructions):
- In AM take one Dulcolax/bisacodyl 5 mg tablet by mouth. Then 30 minutes later one 10 oz bottle of magnesium citrate. If you do not like the magnesium citrate (we bought lemon flavor at CVS, bottle cost $1.29, she said it tastes like flat soda) you can replace it with 1 capful of Miralax (17 grams) in 8 oz of liquid for 3 doses 15 minutes apart (so take 1 dose in 8 oz, then 15 minutes later take 2nd dose in 8 oz, then 15 minutes after that 3rd dose in 8 oz liquid).
- eat lightly during 2 day clean out (since she was so backed up GI recommended 2 days, if not as backed up 1 day may clean her out).
-Maintenance is 1 capful of Miralax in 8 oz of liquid per day.
- Goal of maintenance is to achieve daily, soft, comfortable bowel movements that have the consistency of soft serve ice cream/mashed potatoes. You may need to adjust the Miralax dose to achieve this consistency. When doing this, make dose changes by 1 teaspoon at a time and stay with the new dose for a minimum of 3 days before making the next dose change.
- drink at least 24 oz of water per day
-limit milk to 24 oz per day
-pasta, rice and cheese can be constipating
-fiber such as fresh fruits and vegetables may help but fiber supplementation is not necessary (end of take home instructions).
She started about 9 AM and it took about 3 hours the first day to start the BM's. We stayed home those 2 days and the first day she went often, the second day she went in the morning a few times, and then she was done. Surprisingly she said she did not have any intestinal cramps or pain.
The GI says she recommends staying on the Miralax maintenance dose for twice as long as it took to get constipated which for my daughter was about 3 months. She did have a 1 month follow up with the GI.
I would suggest that a clean out cannot hurt, whether you decide to stay on Miralax or not but I am not a doctor. The GI said that Miralax is a great product but that many people use it incorrectly and inconsistently and then do not get good results. We bought the HUGE bottle of generic Miralax at CVS. We also bought a 20 oz CamelBak drink bottle that she now take with her to school with half water, half juice, and finishes it at the end of the school day. She then has another 8 oz of water with dinner and 8 oz of milk before bed. Good luck.