This topic is about finding a reliable daily bowel movement routine after having a colostomy. The person sharing their experience has been using Miralax mixed with apple juice, but it’s not working as well as it used to. They have a history of constipation and a severe bowel obstruction, which led to their ostomy surgery. They are eager to find practical solutions to ensure at least one bowel movement each day. Here are some helpful tips and insights shared by others:

1. Eat enough food and calories:
- It's important to remember that if you don’t eat enough, you might not have regular bowel movements. Eating too little can reduce output, even if you’re using laxatives.
- Keeping a food diary can help you understand how the amount and type of food you eat affect your bowel movements.

2. Review your overall diet and hydration:
- Track which foods work well for you and which don’t. You can use a diary or a calorie counter book to help with this.
- Make sure you’re drinking enough fluids and compare your current diet and liquid intake with what you used to consume before your ostomy.

3. Consider your stoma type and possible irrigation:
- If you have a descending or sigmoid colostomy, you might find that periodic colostomy irrigation helps you empty your colon on a schedule, which can be reassuring.

4. Re-evaluate your choice and dosage of laxatives:
- You might want to try Milk of Magnesia as an alternative to Miralax. A small dose, like those used in hospitals, could be effective.
- If you find yourself needing a laxative every day, it might be worth discussing with your doctor, as it could indicate an underlying motility issue.

5. Investigate underlying colon function:
- If constipation persists after your colostomy, it might be due to conditions like colonic inertia, where the colon muscles don’t move stool effectively. In some cases, a different surgical approach, such as an ileostomy, might help.
- Remember, having a daily bowel movement isn’t necessary for everyone. Focus on what makes you comfortable and symptom-free.

6. Try a fiber-and-oil morning regimen:
- Mix 3 heaping teaspoons of chia seeds in 8 oz of warm water and let it sit for 5 minutes.
- Stir the gel into ½ cup of mint tea and add 1 tablespoon of olive or coconut oil, then drink it before breakfast.
- After breakfast, try Acacia Senegal (gum arabic) from Heather’s Tummy Care, starting with small doses and gradually increasing.
- Adjust the amount of chia seeds to suit your needs.

These suggestions might help you establish a more reliable routine and bring some peace of mind.