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Step 2: Osmotic laxatives Polyethylene glycol 3350 (Miralax) 17 grams (one capful) daily, dissolved in 8 oz water Magnesium citrate 240 mL as needed for acute relief (not for daily use) Lactulose 15-30 mL daily (prescription) Osmotic laxatives pull water into the colon and stimulate stretch receptors that trigger peristalsis

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It increases stomach acid production, irritates the stomach lining, relaxes the lower esophageal sphincter (promoting acid reflux), and acts as a diuretic that pulls water from your body