What is the recommended bowel reset regimen for an adult patient using MiraLAX (polyethylene glycol)

Adult MiraLAX Bowel Reset Protocol

For an adult bowel reset (not colonoscopy preparation), mix 238-255 grams (entire bottle) of MiraLAX in 64 ounces of Gatorade or other clear liquid (NOT water), and consume 8 ounces every 30-60 minutes over 4-8 hours, starting as early as possible but no later than noon. 1, 2

Preparation Instructions

Mixing the Solution

• Use the ENTIRE bottle of MiraLAX (238 or 255 grams) mixed into 64 ounces of liquid 1, 2
• DO NOT mix with plain water - use Gatorade, other sports drinks, clear juices (apple, white grape, cranberry - NO PULP), lemonade, or Crystal Light 2, 3
• Shake until MiraLAX is completely dissolved 2
• This preparation WILL cause diarrhea and loose, watery, more frequent stools 1

Timing Considerations

• Start taking the solution as early as possible in the morning, ideally by 8:00 AM 2
• Do not start later than noon (12:00 PM), or you will not get adequate sleep 2
• The entire process typically takes 4-8 hours to complete 2

Administration Protocol

Consumption Schedule

• Drink 8 ounces of the MiraLAX solution every 30-60 minutes until the entire solution is gone 2, 3
• If you become nauseated or feel full, stop drinking for at least 30 minutes, then resume with smaller amounts (4-6 ounces) every 45-60 minutes 2
• It is necessary to drink all of the solution to ensure adequate bowel cleansing 2

Expected Results

• Your stool should become liquid and clear enough to see through 2
• The color may be yellow, green, or even blue depending on what liquid you mixed with the MiraLAX 2
• Continue drinking clear liquids even after finishing the MiraLAX solution to maintain hydration and continue flushing your colon 2

Dietary Requirements

Day of Bowel Reset

• You must follow a clear liquid diet ONLY for the entire day of the bowel cleanout 2
• Permitted clear liquids include:
  • Jell-O (no red or purple colors recommended)
  • Popsicles
  • Broth
  • Gatorade or PowerAde
  • Clear fruit juices (apple, white grape, cranberry - NO PULP)
  • Kool-Aid (any flavor)
  • Crystal Light
  • Water 2

Hydration

• Maintain adequate fluid intake throughout the day 4, 2
• Continue drinking clear liquids beyond the MiraLAX solution to ensure proper hydration 2

Important Caveats and Pitfalls

Evidence Limitations

• MiraLAX-Gatorade preparations have shown inferior bowel cleansing compared to standard 4L PEG preparations in multiple studies 5, 6, 3
• However, for bowel reset purposes (rather than colonoscopy preparation), this regimen remains commonly used and generally effective 2, 7

Safety Considerations

• Do not use this regimen if you have known or suspected bowel obstruction 4
• Avoid this preparation if you are at risk for volume overload or electrolyte disturbances 4
• If you experience severe abdominal pain, persistent vomiting, or no bowel movements after several hours, seek medical attention 4

Monitoring Response

• If bowel movements remain brown or solid after completing the preparation, the cleansing may be inadequate 4
• The goal is to achieve clear, liquid bowel movements 2

Alternative Considerations

If this regimen proves ineffective or poorly tolerated, alternative approaches for future bowel resets may include:

• Split-dosing regimens (dividing the preparation over two days) 4
• Addition of stimulant laxatives such as bisacodyl (10-15 mg) or sennosides 4, 8, 2
• Standard 4L PEG preparations, which demonstrate superior efficacy 5, 6, 3