Experience with Ex-lax Protocol for Constipation - TMI

[Anonymous]

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

[Anonymous]

Glad that you finally saw a doctor. No more NPs, they simply do not have the training to practice with as much independence as they do its a serious problem with our Healthcare model.

[Anonymous]

Anonymous wrote:Glad that you finally saw a doctor. No more NPs, they simply do not have the training to practice with as much independence as they do its a serious problem with our Healthcare model.

OP here. While I agree with you in a general sense, with this it’s completely my fault. We saw the doctor initially with DD1 (not the daughter I’m talking about in my original post) but then doctor told us we can follow up with NP. NP’s personality is so much better than the doctor. She’s just nicer and makes you feel comfortable. So by the time DD2 also started having issues we just saw the NP. The red flag I should paid attention to is after being on miralax for years NP was pushing to reduce miralax and I wanted an X-ray for peace of mind before doing that. She kept chalking to it to anxiety on my part and told me that she understands because she’s a worrier as well. She kept insisting that X-rays don’t show anything. GI disagrees with that completely and explained to me how an X-ray can indeed show if a child is severely constipated. I trusted the NP but should have gone with my gut and switched providers. The thing is neither of my daughters have encopresis or bedwetting accidents so there was nothing to suggest that this is a bigger issue. I feel like we didn’t get good care and I blame myself for it

[Anonymous]

Anonymous wrote:

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

We see a doc with Pediatric Specialists of VA in Fairfax. Have seen a couple of providers. They have said the ex-lax is perfectly safe to take and does not cause dependency. It really helps with the urge to go, which prevents withholding. He started with 1 square but we quickly kept bumping him up to 4 squares until that wasn't working as well, and bumped it up to 5. Early on, they had him do an x-ray and he was very much backed up. They let me know some kids can be on even more squares a day. It just depends on what works for each kid and their body. I think there may been a little cramping in the early days as we increased the dosage but nothing too bad. No pain/discomfort with it now, just a really strong urge to go. The miralax cramping/discomfort was much worse. At this point, he takes it around 5:30 and has a large poop in the morning by 7am like clockwork. There may be an additional one during the day (rarely) or in the evening (occasionally). During this process, I've been able to tell if something is off based on if there is any staining in the underwear, extra flatulence or gas, or if the timing of the morning poop goes later and later. Those were the signs for possibly needing increased ex-lax and/or a miralax clean out. Once all that stopped happening, we knew we were at the right dose. Hope that helps.

Please don't beat yourself up about all this. The fact that you're trying to get the right care now for your child is great, just keep advocating if you have any concerns. It's a tough process. Good luck.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

We see a doc with Pediatric Specialists of VA in Fairfax. Have seen a couple of providers. They have said the ex-lax is perfectly safe to take and does not cause dependency. It really helps with the urge to go, which prevents withholding. He started with 1 square but we quickly kept bumping him up to 4 squares until that wasn't working as well, and bumped it up to 5. Early on, they had him do an x-ray and he was very much backed up. They let me know some kids can be on even more squares a day. It just depends on what works for each kid and their body. I think there may been a little cramping in the early days as we increased the dosage but nothing too bad. No pain/discomfort with it now, just a really strong urge to go. The miralax cramping/discomfort was much worse. At this point, he takes it around 5:30 and has a large poop in the morning by 7am like clockwork. There may be an additional one during the day (rarely) or in the evening (occasionally). During this process, I've been able to tell if something is off based on if there is any staining in the underwear, extra flatulence or gas, or if the timing of the morning poop goes later and later. Those were the signs for possibly needing increased ex-lax and/or a miralax clean out. Once all that stopped happening, we knew we were at the right dose. Hope that helps.

Please don't beat yourself up about all this. The fact that you're trying to get the right care now for your child is great, just keep advocating if you have any concerns. It's a tough process. Good luck.

Thank you so much PP. This is so helpful and useful. We are seeing Dr Chao. She said the same - that the amount of exlax just depends on the child. Her recommendation is to start with 3 squares (this would be right after the 2 days initial cleanout). Says must have a bowel movement maximum 14 hours after she has taken the exlax. If not need to increase the exlax by one square until she has that bowel movement 14 hours after.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son had to take daily ex lax (half a square) when he was 4 after a severe situation. The doctor had him take it for 9 months because that's how long it would take for his colon to shrink to a normal size. He's 8 now and doesn't need meds but I still have to remind him to go every night.

Shrink the colon why??

Why does the colon need to shrink won't that make the constipation much worse?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

We see a doc with Pediatric Specialists of VA in Fairfax. Have seen a couple of providers. They have said the ex-lax is perfectly safe to take and does not cause dependency. It really helps with the urge to go, which prevents withholding. He started with 1 square but we quickly kept bumping him up to 4 squares until that wasn't working as well, and bumped it up to 5. Early on, they had him do an x-ray and he was very much backed up. They let me know some kids can be on even more squares a day. It just depends on what works for each kid and their body. I think there may been a little cramping in the early days as we increased the dosage but nothing too bad. No pain/discomfort with it now, just a really strong urge to go. The miralax cramping/discomfort was much worse. At this point, he takes it around 5:30 and has a large poop in the morning by 7am like clockwork. There may be an additional one during the day (rarely) or in the evening (occasionally). During this process, I've been able to tell if something is off based on if there is any staining in the underwear, extra flatulence or gas, or if the timing of the morning poop goes later and later. Those were the signs for possibly needing increased ex-lax and/or a miralax clean out. Once all that stopped happening, we knew we were at the right dose. Hope that helps.

Please don't beat yourself up about all this. The fact that you're trying to get the right care now for your child is great, just keep advocating if you have any concerns. It's a tough process. Good luck.

Thank you so much PP. This is so helpful and useful. We are seeing Dr Chao. She said the same - that the amount of exlax just depends on the child. Her recommendation is to start with 3 squares (this would be right after the 2 days initial cleanout). Says must have a bowel movement maximum 14 hours after she has taken the exlax. If not need to increase the exlax by one square until she has that bowel movement 14 hours after.

We're with Dr. Leibowitz now. Everything you said sounds consistent with our info. I found it helpful to reach out to the nurse with concerns and was able to get a quick response once they checked with the doc.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son had to take daily ex lax (half a square) when he was 4 after a severe situation. The doctor had him take it for 9 months because that's how long it would take for his colon to shrink to a normal size. He's 8 now and doesn't need meds but I still have to remind him to go every night.

Shrink the colon why??

OP here. The rectum needs to fill up for a child to have the urge to have a bowel movement. If the rectum is stretched out it will fill up with a lot of stool the child gets that urge to have a bowel movement. Sometimes a child doesn’t even get the urge anymore and excess stool just leaks out (not dealing with this thankfully). My daughter has a bowel movement every day but her rectum is stretched out. As I understand it, there’s a certain amount of stool that’s just in her rectum that she isn’t completely emptying. Once she eats and her body produces more stool, her rectum fills up completely, she feels the urge and has a bowel movement. Miralax helps keeping that new stool soft but the old stool is still in there. Idea behind a miralax cleanout is to cleanout all the old stool. Problem is that if the rectum is stretched out it will eventually fill up again with lots of stool. So idea is to keep it empty with exlax daily so that it gets the chance to shrink back to normal size.


Why does the colon need to shrink won't that make the constipation much worse?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

We see a doc with Pediatric Specialists of VA in Fairfax. Have seen a couple of providers. They have said the ex-lax is perfectly safe to take and does not cause dependency. It really helps with the urge to go, which prevents withholding. He started with 1 square but we quickly kept bumping him up to 4 squares until that wasn't working as well, and bumped it up to 5. Early on, they had him do an x-ray and he was very much backed up. They let me know some kids can be on even more squares a day. It just depends on what works for each kid and their body. I think there may been a little cramping in the early days as we increased the dosage but nothing too bad. No pain/discomfort with it now, just a really strong urge to go. The miralax cramping/discomfort was much worse. At this point, he takes it around 5:30 and has a large poop in the morning by 7am like clockwork. There may be an additional one during the day (rarely) or in the evening (occasionally). During this process, I've been able to tell if something is off based on if there is any staining in the underwear, extra flatulence or gas, or if the timing of the morning poop goes later and later. Those were the signs for possibly needing increased ex-lax and/or a miralax clean out. Once all that stopped happening, we knew we were at the right dose. Hope that helps.

Please don't beat yourself up about all this. The fact that you're trying to get the right care now for your child is great, just keep advocating if you have any concerns. It's a tough process. Good luck.

Thank you so much PP. This is so helpful and useful. We are seeing Dr Chao. She said the same - that the amount of exlax just depends on the child. Her recommendation is to start with 3 squares (this would be right after the 2 days initial cleanout). Says must have a bowel movement maximum 14 hours after she has taken the exlax. If not need to increase the exlax by one square until she has that bowel movement 14 hours after.

We're with Dr. Leibowitz now. Everything you said sounds consistent with our info. I found it helpful to reach out to the nurse with concerns and was able to get a quick response once they checked with the doc.

Thanks again PP. I feel much more relaxed about the whole thing now.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 5yo is on 5 ex lax squares a day after the smaller doses didn’t work. This dose has been amazing and he’s been stable on the dose for about 5-6 months so we are trying to wean off it now. The ex lax has been much better than the miralax. we were also doing 1-2x a month miralax cleanouts for a few months but don’t need that anymore.
Happy to answer any other questions. He started on ex lax 1 year ago.

OP here. Thank you so much PP. I have a bunch of questions if that’s ok. Who is your GI and what dose did they initially recommend? What did your GI say about dependency? My other huge concern is stomach aches with the exlax due to the urge to poop? Does your son’s stomach hurt everyday because of the exlax or did his body get used to it? If his body got used to it was their stomach pain in the beginning? Also how do you know how to time the exlax properly so that he doesn’t get that urge to poop in the middle of the school day? Thank you so much

We see a doc with Pediatric Specialists of VA in Fairfax. Have seen a couple of providers. They have said the ex-lax is perfectly safe to take and does not cause dependency. It really helps with the urge to go, which prevents withholding. He started with 1 square but we quickly kept bumping him up to 4 squares until that wasn't working as well, and bumped it up to 5. Early on, they had him do an x-ray and he was very much backed up. They let me know some kids can be on even more squares a day. It just depends on what works for each kid and their body. I think there may been a little cramping in the early days as we increased the dosage but nothing too bad. No pain/discomfort with it now, just a really strong urge to go. The miralax cramping/discomfort was much worse. At this point, he takes it around 5:30 and has a large poop in the morning by 7am like clockwork. There may be an additional one during the day (rarely) or in the evening (occasionally). During this process, I've been able to tell if something is off based on if there is any staining in the underwear, extra flatulence or gas, or if the timing of the morning poop goes later and later. Those were the signs for possibly needing increased ex-lax and/or a miralax clean out. Once all that stopped happening, we knew we were at the right dose. Hope that helps.

Please don't beat yourself up about all this. The fact that you're trying to get the right care now for your child is great, just keep advocating if you have any concerns. It's a tough process. Good luck.

Thank you so much PP. This is so helpful and useful. We are seeing Dr Chao. She said the same - that the amount of exlax just depends on the child. Her recommendation is to start with 3 squares (this would be right after the 2 days initial cleanout). Says must have a bowel movement maximum 14 hours after she has taken the exlax. If not need to increase the exlax by one square until she has that bowel movement 14 hours after.

We're with Dr. Leibowitz now. Everything you said sounds consistent with our info. I found it helpful to reach out to the nurse with concerns and was able to get a quick response once they checked with the doc.

Thanks again PP. I feel much more relaxed about the whole thing now.

You're welcome!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son had to take daily ex lax (half a square) when he was 4 after a severe situation. The doctor had him take it for 9 months because that's how long it would take for his colon to shrink to a normal size. He's 8 now and doesn't need meds but I still have to remind him to go every night.

Shrink the colon why??

OP here. The rectum needs to fill up for a child to have the urge to have a bowel movement. If the rectum is stretched out it will fill up with a lot of stool the child gets that urge to have a bowel movement. Sometimes a child doesn’t even get the urge anymore and excess stool just leaks out (not dealing with this thankfully). My daughter has a bowel movement every day but her rectum is stretched out. As I understand it, there’s a certain amount of stool that’s just in her rectum that she isn’t completely emptying. Once she eats and her body produces more stool, her rectum fills up completely, she feels the urge and has a bowel movement. Miralax helps keeping that new stool soft but the old stool is still in there. Idea behind a miralax cleanout is to cleanout all the old stool. Problem is that if the rectum is stretched out it will eventually fill up again with lots of stool. So idea is to keep it empty with exlax daily so that it gets the chance to shrink back to normal size.


Why does the colon need to shrink won't that make the constipation much worse?

This is very interesting. Do you think this still applies to adults too?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son had to take daily ex lax (half a square) when he was 4 after a severe situation. The doctor had him take it for 9 months because that's how long it would take for his colon to shrink to a normal size. He's 8 now and doesn't need meds but I still have to remind him to go every night.

Shrink the colon why??

OP here. The rectum needs to fill up for a child to have the urge to have a bowel movement. If the rectum is stretched out it will fill up with a lot of stool the child gets that urge to have a bowel movement. Sometimes a child doesn’t even get the urge anymore and excess stool just leaks out (not dealing with this thankfully). My daughter has a bowel movement every day but her rectum is stretched out. As I understand it, there’s a certain amount of stool that’s just in her rectum that she isn’t completely emptying. Once she eats and her body produces more stool, her rectum fills up completely, she feels the urge and has a bowel movement. Miralax helps keeping that new stool soft but the old stool is still in there. Idea behind a miralax cleanout is to cleanout all the old stool. Problem is that if the rectum is stretched out it will eventually fill up again with lots of stool. So idea is to keep it empty with exlax daily so that it gets the chance to shrink back to normal size.


Why does the colon need to shrink won't that make the constipation much worse?

This is very interesting. Do you think this still applies to adults too?

OP here. Sometimes I wonder because I have struggled with constipation ever since I had my second. But I’m thinking it may be a pelvic floor issue cuz I have a diastasis and an umbilical hernia as well and my PT says they are the cause of my constipation. What I did notice though is every adult GI that I’ve seen just pushes more fiber and linzess which I’m not interested in taking. No doctor I’ve seen has talked to me about a stretched out rectum and no one has ever ordered an X-ray.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My son had to take daily ex lax (half a square) when he was 4 after a severe situation. The doctor had him take it for 9 months because that's how long it would take for his colon to shrink to a normal size. He's 8 now and doesn't need meds but I still have to remind him to go every night.

Shrink the colon why??

OP here. The rectum needs to fill up for a child to have the urge to have a bowel movement. If the rectum is stretched out it will fill up with a lot of stool the child gets that urge to have a bowel movement. Sometimes a child doesn’t even get the urge anymore and excess stool just leaks out (not dealing with this thankfully). My daughter has a bowel movement every day but her rectum is stretched out. As I understand it, there’s a certain amount of stool that’s just in her rectum that she isn’t completely emptying. Once she eats and her body produces more stool, her rectum fills up completely, she feels the urge and has a bowel movement. Miralax helps keeping that new stool soft but the old stool is still in there. Idea behind a miralax cleanout is to cleanout all the old stool. Problem is that if the rectum is stretched out it will eventually fill up again with lots of stool. So idea is to keep it empty with exlax daily so that it gets the chance to shrink back to normal size.


Why does the colon need to shrink won't that make the constipation much worse?

This is very interesting. Do you think this still applies to adults too?

OP here. Sometimes I wonder because I have struggled with constipation ever since I had my second. But I’m thinking it may be a pelvic floor issue cuz I have a diastasis and an umbilical hernia as well and my PT says they are the cause of my constipation. What I did notice though is every adult GI that I’ve seen just pushes more fiber and linzess which I’m not interested in taking. No doctor I’ve seen has talked to me about a stretched out rectum and no one has ever ordered an X-ray.

SAME. I also have constipation, endo, IBS and umbilical hernia not sure what is causing what at this point. I've never been given an xray and just told to take stool softeners, milk of mag, citricul for decades now. But I wonder if shrinking the colon would help it work better.