This topic is about managing low gut motility for someone with a permanent ileostomy. The person has been dealing with slow gastrointestinal motility since childhood and is exploring ways to improve their condition without adding more prescription medications. They have started using a half-dose of Miralax each morning and are seeking advice from others with similar experiences.

Here are some insights and advice shared by others:

1. Seek further medical evaluation:
- It's important to get a second opinion or consult a specialist, as long-standing motility issues and surgical history might not have been fully addressed.
- Consider consulting both conventional and integrative practitioners, but make sure to gather enough information to make informed decisions about treatments.

2. Miralax (polyethylene glycol 3350) usage:
- Many people have been advised by their doctors to use Miralax daily, as it is generally considered safe and non-habit-forming. It works by drawing water into the bowel.
- If you use Miralax regularly, make sure to drink extra fluids to compensate for the water being drawn into the gut.
- Using a half-dose or adjusting the dose to your needs is common. It's important to monitor your response and discuss it with a healthcare provider.

3. Alternative or adjunct products:
- Some have found that using Benefiber (wheat dextrin) daily helps with slow motility, while Miralax is used occasionally.
- Reglan can help improve motility for some people, but its side effects may limit long-term use.
- Imodium (loperamide) can be useful to manage sudden high output or dumping syndrome.

4. General management strategies:
- Be prepared for some trial and error, as different combinations of fiber, osmotics, pro-kinetics, and diet may be needed to balance slow baseline motility with episodes of high output.
- Keep an eye on hydration and electrolyte levels, especially with an ileostomy, when adjusting laxatives or fiber supplements.