From the Guidelines
People with an ileostomy should not take Miralax (polyethylene glycol) as it can increase output from the stoma, leading to dehydration and electrolyte imbalances. The primary concern for individuals with an ileostomy is managing high output rather than constipation, as the digestive physiology is significantly altered due to the diversion of stool before it reaches the large intestine 1.
Managing Ileostomy Output
Instead of using laxatives like Miralax, individuals with an ileostomy may need to focus on managing their output through other means, such as:
- Increasing fluid intake to prevent dehydration
- Adjusting their diet to reduce output
- Using specific medications designed for ileostomy management, such as anti-diarrheal medications like loperamide 1
- Considering the use of thickening powders or oral rehydration solutions to help manage output and prevent malnutrition 1
Importance of Healthcare Provider Guidance
It is essential for individuals with an ileostomy to consult their healthcare provider for personalized guidance on managing their output and preventing complications such as dehydration and electrolyte imbalances. The healthcare provider may recommend specific treatments or interventions based on the individual's unique needs and medical history.
Key Considerations
- The use of Miralax or other laxatives is not recommended for individuals with an ileostomy due to the risk of increasing output and causing dehydration and electrolyte imbalances 1
- Managing high output is a critical aspect of ileostomy care, and individuals should work closely with their healthcare provider to develop an effective management plan
- A multidisciplinary approach to intestinal rehabilitation is essential for successful management of ileostomy patients, particularly those with high-output enterostomy or severe diarrhea 1
From the Research
Medication Absorption for Ileostomy Patients
- The absorption of medications can be affected in individuals with an ileostomy, and it is essential to consider this when prescribing medications 2.
- There is limited literature available on the absorption of specific medications, including Miralax (Polyethylene Glycol), in patients with an ileostomy.
Use of Polyethylene Glycol (Miralax) in Ileostomy Patients
- A study comparing the efficacy of Miralax with GoLytely for bowel cleansing before screening colonoscopies found that Miralax was not as effective as GoLytely 3.
- However, this study did not specifically address the use of Miralax in patients with an ileostomy.
- Another study investigated the use of bisacodyl plus polyethylene glycol (PEG) for bowel preparation in hospitalized patients, but it did not focus on ileostomy patients specifically 4.
Considerations for Medication Management in Ileostomy Patients
- It is crucial to assess each patient's medication regimen to identify potential absorption issues 2.
- Clinical pharmacists can play a vital role in optimizing drug therapy for patients with an ileostomy, and their interventions can lead to improved patient outcomes 5.
- More research is needed to provide evidence-based guidance on medication management for patients with an ileostomy, including the use of Miralax (Polyethylene Glycol) 6, 5, 2.