Step 1 | Start 2 to 4 teaspoons (4.5 teaspoons = 17 g) of PEG 3350 (eg, MiraLax, GlycoLax) once daily in 4 to 8 ounces (120 to 240 mL) of noncarbonated beverage (or appropriate dose of another laxative). Dietary counseling to add dietary fiber and extra liquids to the diet each day. |
Step 2 | Increase or decrease PEG 3350 by 1 to 2 teaspoons every 2 to 3 days, until the desired result of daily soft stools is achieved. Maximum dose is 1 heaping tablespoon (17 g) twice daily. |
Step 3 | Follow-up by phone or a return visit within 1 month to be sure the laxative is effective. |
Step 4 | Continue to add dietary fiber and extra liquids to the diet each day. |
Step 5 | After 6 to 8 weeks of soft daily bowel movements, begin to taper the dose of PEG 3350 by 0.5 to 1 teaspoon every 2 weeks, until daily movements continue without the need for a laxative. |
Step 6 | If stools become hard again, increase the dose slightly and retry weaning off the laxative in another 6 to 8 weeks. |
Step 7 | This process may take from 2 to 4 weeks to 6 months, but the end result should be resolution of the constipation. |
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