Here's the clinical reality of the Doctor's Favorite.
MiraLAX suppresses the constipation symptoms by forcing water into the colon through osmosis. For chronic constipation, it does what it's designed to do: create bulk pressure that moves stool. Cycle regularity seems to improve. Some constipation symptoms reduce.
But about 90% of chronic constipation cases comes from the bacterial source — not the stool output.
MiraLAX was never designed to address the bacterial source. The osmotic laxative running bowel movements continues underneath the suppression, undisturbed for as long as you stay on it.
Which is why the patient who wants to come off — to assess her natural cycle, to consider pregnancy, to stop medicating a body she wants to understand — everything returns. The bacterial depletion was running the entire time. The constipation suppression was masking it.
I prescribe osmotic laxatives. For the right patient, for the right reason, for the right phase. But as a solution to chronic constipation restoration? It addresses one source while the other runs underneath it indefinitely. And it produces zero lasting change in the bacterial environment once she returns to her day-to-day life.