Miralax, with its active ingredient polyethylene glycol 3350 (PEG 3350), is an osmotic laxative that works by drawing water into the colon to soften stool and make bowel movements easier [1.8.3]. While effective for many, some people seek alternatives due to side effects, cost, or personal preference. Fortunately, a wide array of substitutes is available, from other over-the-counter (OTC) medications to natural remedies and lifestyle changes.
Before switching, it is important to consult a healthcare provider to ensure the chosen alternative is appropriate for your individual health needs [1.2.2].
Over-the-Counter (OTC) Pharmacological Substitutes
Laxatives are categorized by how they work. Understanding these categories can help you find a suitable Miralax alternative [1.2.2, 1.10.2].
Other Osmotic Laxatives
These work similarly to Miralax by pulling water into the intestines.
- Magnesium Citrate (e.g., Citroma): This saline laxative works faster than Miralax, typically producing a bowel movement within 30 minutes to six hours [1.9.1]. It's a liquid solution often used for occasional, more urgent relief [1.2.2].
- Magnesium Hydroxide (e.g., Milk of Magnesia): Another osmotic laxative that draws water into the intestines to produce a bowel movement, usually within 30 minutes to six hours [1.2.2, 1.8.3].
- Lactulose (e.g., Enulose, Kristalose): A prescription osmotic laxative that takes one to two days to work [1.6.5]. Studies show PEG 3350 may be more effective and have fewer side effects [1.4.4].
Bulk-Forming Laxatives
Often considered the gentlest type, these fiber supplements absorb water to increase the bulk and softness of your stool, stimulating a natural contraction of the colon [1.10.2]. They can take 12 to 72 hours to work [1.2.5]. It's crucial to drink plenty of water with them to prevent choking or worsening constipation [1.10.1, 1.2.5].
- Psyllium (e.g., Metamucil): A soluble fiber that can be used daily to maintain regularity [1.2.5].
- Methylcellulose (e.g., Citrucel): Another fiber-based option that increases stool bulk [1.2.3].
- Polycarbophil (e.g., FiberCon): A bulk-forming laxative that helps make stool bigger and softer [1.10.2].
Stool Softeners (Emollients)
Stool softeners add moisture and fats to the stool, making it softer and easier to pass without stimulating a bowel movement directly [1.6.1, 1.11.4]. They are often recommended to prevent straining after surgery or for those with conditions like hemorrhoids [1.4.2].
- Docusate (e.g., Colace): This is the most common stool softener. It typically works within one to three days [1.2.2, 1.8.3].
Stimulant Laxatives
These are more powerful and intended for short-term use. They work by stimulating the nerves in the intestinal walls, causing the muscles to contract and move stool along [1.11.1, 1.10.3]. They generally produce a bowel movement in six to 12 hours [1.11.4].
- Bisacodyl (e.g., Dulcolax): A common stimulant used for occasional constipation [1.2.2].
- Senna (e.g., Senokot, Ex-Lax): An herbal stimulant laxative [1.2.3].
Comparison of Common Miralax Alternatives
| Medication | Type of Laxative | Mechanism of Action | Time to Effect |
|---|---|---|---|
| Miralax (PEG 3350) | Osmotic | Draws water into the colon to soften stool [1.8.3]. | 1 to 3 days [1.9.1]. |
| Metamucil (Psyllium) | Bulk-Forming | Absorbs water to increase stool bulk and softness [1.2.5]. | 12 to 72 hours [1.2.5]. |
| Magnesium Citrate | Osmotic (Saline) | Draws water into the intestines to increase liquidity [1.9.1]. | 30 minutes to 6 hours [1.9.1]. |
| Colace (Docusate) | Stool Softener | Allows water and fat to penetrate the stool, softening it [1.6.1]. | 1 to 3 days [1.2.2]. |
| Dulcolax (Bisacodyl) | Stimulant | Stimulates intestinal muscle contractions [1.11.1]. | 6 to 12 hours [1.11.4]. |
Natural and Dietary Alternatives
A holistic approach combining diet and lifestyle can be highly effective for managing and preventing constipation.
Increase Fiber and Fluid Intake
- Eat More Fiber: Adults should aim for 22 to 34 grams of fiber daily from sources like fruits (apples, berries, prunes), vegetables (broccoli, Brussels sprouts), whole grains, and legumes [1.5.2, 1.3.4]. Prunes are particularly effective as they contain both fiber and sorbitol, a natural laxative [1.2.2].
- Stay Hydrated: Increasing fiber without enough water can worsen constipation [1.3.3]. Drink plenty of fluids, with a general goal of around eight 8-ounce glasses of water per day [1.5.1].
Other Natural Aids
- Probiotics: Found in yogurt, kefir, and supplements, probiotics can help create a healthy gut environment [1.3.2, 1.2.2].
- Coffee: For many, caffeinated coffee stimulates the muscles in the digestive system, increasing the urge to have a bowel movement [1.2.2].
- Kiwi: Research has shown that eating two kiwis per day can improve stool consistency and reduce bloating [1.3.2].
Lifestyle Modifications for Constipation
Simple changes to your daily routine can make a significant difference in bowel regularity.
- Get Regular Exercise: Physical activity helps decrease the time it takes for food to move through the large intestine and stimulates intestinal muscle contractions [1.5.1]. Even a 10-15 minute walk after a meal can be beneficial [1.5.1].
- Establish a Routine: Try to have a bowel movement at the same time each day, such as 15 to 45 minutes after breakfast, to take advantage of the body's natural reflexes [1.5.2].
- Don't Ignore the Urge: Resisting the urge to have a bowel movement can contribute to constipation [1.5.1]. Go when your body signals it's time.
- Consider Your Position: Using a footstool to elevate your knees above your hips (simulating a squat) can help straighten the colon and make passing stool easier [1.3.5].
Conclusion
While Miralax is a widely used and effective treatment for occasional constipation, numerous substitutes are available. The best alternative depends on the cause and severity of your constipation, your personal health history, and how quickly you need relief. Options range from other osmotic laxatives like magnesium citrate for faster action, gentle bulk-formers like Metamucil for regular maintenance, and stool softeners like Colace for preventing strain. Furthermore, integrating high-fiber foods, adequate hydration, and regular exercise into your lifestyle can provide a long-term solution. Always consult with a healthcare professional before starting or switching laxatives to find the safest and most effective option for you [1.2.2].
