This topic is about a person who has been living with an ileostomy for four years and is experiencing severe constipation. Their doctor believes this is due to slow transit rather than a blockage. The doctor suggested using Miralax, but the person is unsure if it's safe for someone with an ileostomy and is seeking advice from others who might have similar experiences.

Here are some insights and advice shared by the community:

1. Miralax (polyethylene glycol 3350)
- It is generally considered a stool-softener or osmotic agent.
- One person with an ileostomy mentioned that Miralax quickly drew fluid from their small intestine, leading to a bag full of water and a higher risk of dehydration.
- The general consensus is that Miralax can be effective, but it's important to monitor hydration closely. Since individual responses can vary, it's best to start cautiously if you decide to use it.

2. Alternative over-the-counter laxatives and stool modifiers
- Metamucil (psyllium) was helpful for one person without causing drastic effects.
- Dulcolax (bisacodyl) led to excessive output for another user, while DulcoEase (docusate) had gentler results.
- The effectiveness and tolerance of these products can differ from person to person, so it's advisable to start with a low dose and adjust slowly.

3. Foods and beverages that can speed up output for some ileostomates
- Dairy products like milk and ice cream.
- Lettuce and many raw greens.
- Pasta and certain processed lunch meats.
- 100% natural fruit juices, such as grape juice and apple juice.
- Regular (sugared) Coca-Cola consumed quickly.
- Slim-Fast or similar liquid breakfasts.
- It's a good idea to keep these "flushing" items on hand for future slow-downs.

4. Hydration considerations
- People with an ileostomy already lose a lot of fluids, and using laxatives or flush-through foods can worsen dehydration.
- It's important to increase oral fluids, such as water and electrolyte drinks, whenever using Miralax or any other agent that increases output.

5. General strategy recommended by multiple members
- Managing constipation with an ileostomy often involves trial and error.
- Keeping a personal log of foods, drinks, medications, and their effects on stoma output can help identify reliable triggers or solutions.
- It's important to determine whether the issue is "thick, sluggish output" or "complete stoppage," as the approaches to managing these may differ.