I would definitely prefer to be on a much more natural alternative.. I'm aware of options 1 and 2 that you listed but haven't heard of the others. Thanks, will look it up..
Long term effect of Miralax can be Pancreatitis.
To prevent constipation,
- You can try Mag citrate tablets. Ramp up the dose slowly, like 200mg once, then twice and then 3X a day. If it doesn't address constipation in 2-3 weeks, add one more tablet on top of this regimen. If not addressed within 2-3 weeks, add one more. At one point, you will get loose stools. Maintain 2/3rd of that dose to prevent constipation.
What is not good about this option. It flushes out your gut flora. If your remission is finicky (and you are still on steroids), then there is a good chance, it will backfire into a flare.
- Try Psyllium seed powder (NOT Metamucil, its husk, not soluble, rubs the intestinal wall). The seed powder contains soluble fiber. It may help. Try eating flaxseed as well (not roasted ones). Chew as much as you can. more you chew, more fiber is available.
- Try Acetyl L-carnitine1-1.5gm in divided doses. Sometimes there is a mitochondrial dysfunction (not disease). As a result, the peristalsis becomes a difficult process, ending up in constipation. Along with this, you could also show other symptoms like getting tired very quickly, muscle soreness etc.
- Ask GI to Rx you Metoclopramide. You will have to play around with the doses. When I get a migraine, peristalsis completely stops leading to severe nausea. 20mg Metoclopramide and I don't get those symptoms.
Research everything before trying. I do all of these and they work with me, does not mean it will work with you too.