This topic is about finding alternatives to Miralax for someone who has a colostomy and a kidney transplant. The person is concerned that Miralax is causing dehydration, especially since they already have trouble drinking enough fluids. They are looking for safe and effective laxatives or methods that won't affect their kidney function.

Here are some helpful insights and advice:

1. Miralax Dosing
- Miralax is a longer-acting osmotic laxative. It's typically used once in the morning and once at night, with an optional dose in the afternoon if really needed. Taking it with every meal can lead to dehydration, which is a concern for anyone, especially those with an ostomy.

2. Consider a Stimulant Laxative
- You might try Bisacodyl (Dulcolax) or Senna tablets, taking 1-2 tablets twice daily. These stimulants help move stool without pulling extra water from your body, making them less likely to cause dehydration.

3. Anti-diarrheal or Motility-modifying Options
- Discuss with your doctor the possibility of using Lomotil (diphenoxylate/atropine).
- Another option could be Viberzi (eluxadoline), which has been prescribed to help regulate output for someone with both a kidney transplant and an ostomy. However, Viberzi is not suitable if you don't have a gallbladder, so it's important to talk to your transplant and GI teams about this.

4. Equipment Tips for Better Leakage Control
- To reduce fluid loss and skin irritation, consider using a Marlen Mini-Max 7-inch One-Piece Drainable Convex Opaque pouch with a filter, along with Coloplast barrier strips. This combination helped one person stop frequent leaks.
- If you're experiencing daily leakage with Hollister pouches, switching brands might solve the issue.

5. Hydration Strategies
- To make drinking water more enjoyable, try using flavored "Water Enhancer" concentrates. Having a variety of flavors can encourage you to drink more fluids, which is important for staying hydrated.