You can manage chronic constipation in kids!
You can manage chronic constipation in kids!
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MiraLax, part 2: Risk versus Reward

I finished writing my last blog post about MiraLax and immediately wanted to write another post addressing the many worries that some people have about MiraLax. 

I’ve heard a lot of them in my career: "MiraLax turned my kid into a nightmare." "It gave her seizures." "It made him so angry he hit a wall." "He was totally normal and then started having the symptoms of autism as soon as he started on MiraLax."

Oh. My. Goodness. These are real struggles, and I don’t want to discount the wisdom of the parents who attribute these challenges to MiraLax. 

And, listen, I have my complaints about MiraLax as well. It can give my patients little wormy poops that border on diarrhea. It can make kids super gassy, and the gassy poop that results is, well, gross. It can actually cause fecal incontinence, because the new, soft MiraLax poop goes around old, harder poop in the rectum and leaks without the child knowing that it’s there. 

So why do I keep backing up the many doctors who prescribe MiraLax for my patients? Why do I check in with patients every week to make sure they are taking their medicine as prescribed, and sometimes even suggest they increase it or do another clean-out? 

First, and most importantly, because MiraLax is safe, at least as far as we know. Click here for a link to a summary of the research of MiraLax use in kids. 

Second, because of all the hundreds of kids I’ve seen, I feel fairly confident in saying that 95% of them make significant improvements if they are taking their laxatives (usually MiraLax) as prescribed. They see these results quickly, and they have fewer relapses. When I see a family that is trying to treat chronic constipation without laxatives, the child just doesn’t fully recover. They improve slightly by doing all that I recommend in The Constipation Game Plan, but they also regress quickly as soon as the initial hyper-vigilant stage is over. 

MiraLax is more effective than Lactulose. It's tolerated better than enemas or suppositories. It's easier to dose than magnesium. And it's the laxative that pediatricians are the most comfortable with. 

Here’s my take on it: Many of the perceived adverse effects of MiraLax are actually attributable to chronic constipation: anger, irritability, stomach aches, anxiety... In most cases, it’s not the MiraLax causing the symptoms, it’s the big old mass of stool hanging out in the colon and rectum.

As for MiraLax actually causing ADHD or autism, I have seen no research confirming this. Constipation is so prevalent in kids with these conditions; it's not hard to imagine a scenario in which they start taking MiraLax at the same time new symptoms of their ADHD or autism appear. Families might attribute the symptoms to the MiraLax, but those symptoms likely were going to appear regardless of what laxative the child was taking. As many of you learned in your high school science classes, correlation isn’t the same as causation. 

So many millions of kids across this country take a daily MiraLax dose. I can’t say with 100% certainty that MiraLax is 100% safe in all of those kids. (From what I understand, all medications will have adverse reactions in at least some patients.) But I know the risks of not treating chronic constipation in kids effectively are great: lower health-related quality of life, increased rates of depression and anxiety, lower self-esteem, higher risk of recidivism in school. Recommending MiraLax is a risk that, based on what the research shows us right now, I can live with.  

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