How to help when there is trouble with bowel movements

In addition to following general healthy guidelines, the care team recommends staying on a “maintenance” bowel plan to keep regular and healthy bowel movements. Follow the plan every day to prevent constipation from causing a backup of stool.

These are general guidelines for a "maintenace" bowel plan. Ask the care team about specific guidelines for the person you care for.

Stool softener

We usually suggest Miralax® (polyethylene glycol)

How it works

Moves water from the body to the intestines to soften stool. Miralax is safe to use in both children and adults.

How to give Miralax®

    1. Check the Bristol Stool Chart to see which type of bowel movement the care team is treating.

    2. Mix __________ capfuls / teaspoons with a favorite drink. Give __________ times per day. *When using Miralax®, 1 capful = 4 teaspoons

    3. After a few days, adjust the dose of Miralax® up or down, depending on the type of bowel movement.

      • For bowel movements Type 1 and 2, increase Miralax® by __________ more until bowel movements reach Type 3, 4 or 5.

      • For bowel movements Type 6 and 7, decrease Miralax® by __________ less, until bowel movements reach Type 3, 4 or 5.

If more than 24-48 hours (1-2 days) has passed without a bowel movement, ask the care team for next steps.

Stimulant laxatives

We suggest a variety of over-the-counter medications. Find one that works well for the individual’s needs.

How it works

Helps the muscles in the colon (large intestine) contract to move stool out of the body.

How to give stimulant laxative

How you give stimulant laxatives depends on which kind you give. Depending on the need, give daily or as directed by the care team.

Choose just ONE of the following:

  • Senna or Ex-Lax®: __________ tablets/squares
  • Dulcolax® or bisacodyl: __________ tablets
  • Magnesium Natural Calm® Mix __________ teaspoons into a favorite drink.
  • Magnesium oxide tablets: __________ tablets
  • Pedia-Lax®: __________ watermelon chews

If more than 24-48 hours (1-2 days) has passed without a bowel movement, ask the care team about next steps.


Mass General for Children and Massachusetts General Hospital do not endorse any of the brands listed on this handout. This handout is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.

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