Information for Patients taking Macrogol

Constipation is a very common problem. It can occur for many reasons, such as not enough fibre in your diet, a medical condition, medication that you might be taking, or even because you are under stress. Some of the symptoms of constipation are:

• pain in the abdomen or rectum
• feeling bloated
• straining to pass hard or lumpy stools
• the sensation of incomplete evacuation.

You have been recommended to use Macrogol for your constipation. Your stools need to be regulated to a type 4 on the Bristol Stool Scale (diagram below).

What is Macrogol?

Macrogol come in sachets. It can also come in other branded names such as Movicol, Movicol Half, Laxido, CosmoCol and Molaxole. It is a powder that requires dilution with water. Macrogol and other osmotic laxative brands are available in lemon, chocolate or plain flavours. Only the plain version is available for Movicol Half. It is very important to dilute the sachet with the correct volume of water printed on the sachet. These are:

• Macrogol – each sachet must be dissolved in 125mL of water, eg two sachets would
  require 250mL.
• Movicol Half – each sachet must be dissolved in 62.5mL of water, eg two sachets
  would require 125mL.

This is because it is a ‘macrogol aperient’ meaning the powder works as a medium effectively ‘locking’ the water into the stool to hydrate it. An incorrect dilution ratio will reduce its effect.

What dose do I take?

You will have been started on either the full or half sachet and given instructions on how many sachets to take over the first few days. After this time, you need to assess your stools using the Bristol Stool Chat diagram below. If your stools are a type 4, please continue on this regime. However, if your stools remain too firm, increase the amount of Macrogol, or if too loose, decrease the amount.

Increasing or reducing the number of sachets you take each day is not the only way to vary the amount. For example, you may reduce to alternate days or twice weekly. Similarly, if you find that one sachet is insufficient, but a second makes your stools too soft or loose, you can use a proportion of either sachet, but the amount of water you use MUST be equally adjusted. For example:

• Taking half of a Movicol Half sachet (normal dilution 62mL) – dilute with 31 mL of water.
• Taking a third of a Macrogol sachet (normal dilution 128mL) – dilute with 42 mL of water.

Do not be concerned if it takes several weeks or more of adjusting the amount of Macrogol before you achieve a type 4 stool. You may find the Bristol Stool Chart below helpful to see how your bowels are working.

Remember

Remember certain foods and medications can have their own laxative or constipating effect, eg eggs can make your motions harder, while chocolate may loosen them. If this occurs, you will need to adjust the amount of Macrogol/Movicol Half you take. If you require any further information, please read the medicines leaflet provided with this medicine or contact your pharmacy.

Contact numbers

For further copies of the Macrogol advice leaflet incorporating the Bristol Stool Chart, or should you have any further queries, please Pelvic Floor Specialist Nurse Nicola Davie on 01305 254810.

About this leaflet

Author: Jane Curtis RGN DPSN, Consultant Pelvic Floor Nurse, December 2018
Updated: Nicola Davies, Pelvic Floor Specialist Nurse, February 2023
Approved: March 2023
Review date: April 2026
Edition: V2

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk