Brief Answer:
Severe constipation.

Detailed Answer:

Hi,

MiraLax (polyethylene glycol 3350) is a laxative solution that increases the amount of water in the intestinal tract to stimulate bowel movements. MiraLax is used as a laxative to treat occasional constipation or irregular bowel movements. The drug works by bringing water into the bowels, which helps keep the digestive system regular. Stool becomes softer when the bowels retain water. At one time, laxative use was discouraged because it was believed it would create a "lazy" bowel, one that became dependent on the laxative. Most texts now believe that's not the case. Long-term laxative use is safe when prescribed by a doctor. MiraLax is an osmotic laxative.

Enema-treating constipation or cleansing the bowel before certain medical procedures. It may also be used for other conditions as determined by your doctor.

Sodium phosphates enema is a saline laxative. It works by pulling water from the body into the bowel, which helps to soften the stool and cause a bowel movement.

Manual evacuation of bowel:
Digital evacuation is the use of fingers to aid in the removal of stool from the rectum. This may be done by a person who is experiencing severe constipation. If hardened stool is palpable in the rectum, it may require manual fragmentation or disimpaction. It is done usually when stools are hardened even after softener use.

Advice- There are many ways.
- You can either go for Miramax in doses which suits you.
- Second is that you could go for enema every alternate day.
- Thirdly you can go for manual digital extraction also.

Though not asked, some general measures which will help you more are:
- Increase XXXXXXX warm water intake
- Eat plentiful "fresh oranges" and "pear"
- Do some exercise everyday as per your capacity try to take a 20 minute walk.
- Don't worry too much.
- Take a diet which is low in Fat.
- Add lot of vegetables and fruits to your diet.
- Fruit juices should be taken along with fibers.
- Take small amount of food every 2 hours; don't take large meals at one time; eat small meals (rich in fiber); avoid eating outside for few days; try to eat vegetable; take a lot of yogurt along with food.
- Take two tea spoon isphagula husk (husk fiber) with 200 to 300mL XXXXXXX warm water once while going to bed every day. Don't take excess husk as too much of anything is good for nothing.
- Avoid COLD milk and and AVOID junk food (NO burger, pizza-even if its veg.)
- Avoid beverages / alcohol/ soft drinks
- Do some exercise (push-ups / squats etc) early in the morning
- Avoid carbonated drinks
- Take 2-3 spoon edible virgin olive oil in the morning.
- Take lots of probiotics like VSL#3 they improve the count of good bacteria in gut and improves digestion.
-Take 10 gram Metamucil once daily before going to bed.

You will feel better in a week.

Regards,
Dr. Ramesh Kumar
Gastroenterologist

---