From the Guidelines
Miralax (polyethylene glycol 3350) can be administered rectally as a bowel cleanout for severe constipation or impaction when oral administration isn't possible or effective, as it is an osmotic laxative that can help draw water into the bowel and soften stool. According to the most recent and highest quality study, 1, osmotic laxatives such as polyethylene glycol are preferred options when laxatives are needed. To administer Miralax rectally, mix 17 grams (one capful) with 4-8 ounces of water until completely dissolved. Draw the solution into a large syringe without a needle, or use an enema kit. Lubricate the tip with water-soluble lubricant, insert gently into the rectum, and slowly administer the solution. Have the patient retain the solution for 10-15 minutes if possible before evacuating. This method works by drawing water into the bowel, softening stool and stimulating evacuation. For severe impaction, this may need to be repeated, but consult a healthcare provider first.
Some key points to consider when administering Miralax rectally include:
- The use of rectal suppositories or enemas should be avoided in patients with neutropenia or thrombocytopenia, as stated in 1.
- Enemas should be used sparingly with awareness of possible electrolyte abnormalities, as mentioned in 1.
- The goal of laxative therapy is to achieve one non-forced bowel movement every 1 to 2 days, as stated in 1.
- Other treatment options, such as stimulant laxatives, opioid rotation, or peripherally acting mu opioid receptor antagonists, may be considered if constipation persists, as discussed in 1.
It is essential to note that rectal administration of Miralax may cause discomfort, cramping, or local irritation, so proceed gently and stop if significant pain occurs. This approach should be considered temporary, with transition to oral laxatives when possible.
From the Research
Bowel Preparation and Laxatives
- The use of laxatives, such as polyethylene glycol 3350 (PEG 3350) and senna, is common in bowel preparation for colonoscopy and treatment of constipation 2, 3, 4, 5, 6.
- PEG 3350 is an osmotic laxative that is effective and safe for both long and short term treatment of pediatric functional constipation 3.
- Senna is a stimulant laxative that can be used as an adjunct therapy in specific clinical scenarios 3.
- The combination of low volume PEG and senna has been shown to be effective and have fewer side effects compared to high volume PEG alone for bowel preparation 4.
MiraLAX (Polyethylene Glycol 3350) in Bowel Preparation
- MiraLAX is a brand name for PEG 3350, which is commonly used for bowel preparation and treatment of constipation 3, 4, 5, 6.
- The efficacy and safety of MiraLAX for bowel preparation have been established in several studies 4, 5, 6.
- However, the optimal dosage and regimen for MiraLAX in bowel preparation are still being studied and debated 4, 5, 6.
Giving MiraLAX in Bowel Preparation
- The decision to give MiraLAX in bowel preparation should be based on individual patient needs and medical history 2, 3, 4, 5, 6.
- The dosage and regimen of MiraLAX should be determined by a healthcare professional and may vary depending on the patient's age, medical condition, and other factors 4, 5, 6.
- Patients should be instructed on how to take MiraLAX and what to expect during bowel preparation, including potential side effects and complications 4, 5, 6.