This topic is about managing a colostomy, particularly when dealing with irregular bowel movements. The person sharing their experience has had a colostomy since 2015 and is facing issues with infrequent output followed by difficult evacuations, despite maintaining a good diet, hydration, and activity level. They are curious about the safety of using Metamucil or stool softeners daily to help with regularity. Here are some insights and advice shared by others:

1. Docusate Sodium (Colace; 100 mg daily)
- Often prescribed for the first week after hospital discharge. It's mild, affordable, and available over the counter.
- Some people add a tablet of Senna occasionally if they need extra help.

2. Senna (sennosides)
- Acts as a mild stimulant for some, but one person experienced an allergic reaction and stopped using it.
- Others use 1–2 tablets when output slows down, even with daily Miralax use.

3. MiraLAX / Generic Polyethylene Glycol 3350 (PEG 3350)
- Many people take a full dose daily, sometimes mixed into their morning coffee.
- Some have been advised by their surgeons to continue using it until a planned reversal surgery.
- One person with a challenging colostomy takes RestoraLAX (Canadian PEG 3350) 4–6 times a day, with their surgeon confirming it's safe for long-term use.
- Others use it only when they haven't had output for a few days or when the stool is very thick.

4. Metamucil (psyllium husk)
- One person takes 2 teaspoons in 8 oz of water three times daily, following Mayo Clinic guidelines, and finds it helps with both loose and hard stools.
- Another user appreciates Metamucil for improving stool consistency and relieving acid reflux.
- A surgeon advised one patient to avoid Metamucil unless they can drink a lot of water, suggesting PEG 3350 as an alternative.

5. Other Products
- Dulcolax (bisacodyl) was found too strong by one person.
- DulcoEase (docusate with softening agents) is gentler and preferred by another.

6. General Recommendations
- Start with the mildest option, like docusate or PEG 3350, and adjust the dose based on personal response.
- Always check with a healthcare provider or surgeon before using any product long-term or in high doses.
- Ensure adequate hydration, especially when using fiber products like Metamucil.