With regard to the thread on constipation... the following is an  
article that I wrote for the HAPS (Houston Area Parkinson's Society)  
newsletter.  It may have something in it that someone will find  
helpful...

for other articles, go to www.hapsonline.org

nina

KEEP ON MOVING...


Parkinson’s is a movement disorder, yet one of the least discussed  
“movement” problems is constipation. Although it can be a concern for  
anyone, it is a common complaint and a troublesome symptom for those  
living with Parkinson's. To make matters worse, the side effects of  
most of the drugs used for Parkinson’s increase the tendency toward  
constipation.

The rigidity and slowness that occurs in Parkinson’s also affects the  
muscles controlling the bowels. Because the bowels move slowly, stool  
moves slowly; and the fluid that's required for proper consistency  
dries out, making the stools hard. The longer the stool takes to pass  
through the bowel, the harder it becomes, and the more difficult it  
becomes to pass. Because it takes longer, one study defined  
constipation as less frequent bowel movements, rather than difficulty  
with defecation. It’s not necessary for most people to have a bowel  
movement every day. Three bowel movements per week is considered  
normal; whereas two or less per week is considered constipation.

Constipation occurs in 30% of people with Parkinson’s. However,  
depending on the length and severity of their Parkinson’s, 70% have  
difficulty completing a bowel movement and may strain or not  
completely evacuate.

Constipation should be well-managed otherwise chronic constipation can  
cause serious complications, such as:

  Lethargy

  Nausea and abdominal pain

  Twisted or obstructed bowel

   Bowel incontinence

  Urinary incontinence caused by pressure against the bladder

  Urinary tract infections

===

A few suggestions follow that might help ease your bowels and ease  
your mind.

Avoid unnecessary medicines that contain substances known to cause  
constipation such as calcium and aluminum.

  Get treatment for any medical problem that may be contributing to  
the constipation, such as hemorrhoids.



    Dietary changes. Dietary fiber is indigestible. If you don’t have  
a problem chewing or swallowing, adding high fiber foods to your diet  
will increase the bulk of the stool and prevent constipation. If you  
do have a problem chewing or swallowing, try grating your food or use  
a blender to get the necessary roughage. Include the skin, where most  
of the fiber is found.  At least two meals a day should include high- 
fiber foods such as grains and raw vegetables (carrots, cauliflower  
and broccoli) or nuts and dried fruits (raisins, prunes or apricots.)   
Some high-fiber snack foods are sesame bread sticks, date nut bread,  
oatmeal cookies, fig newtons, granola, raisin bars and corn chips.   
You can add fiber by sprinkling bran into applesauce or yogurt or on  
cereal; however, bran should be avoided if you have swallowing  
problems.  Also, be aware if you add milk to cold cereal, the protein  
in the milk can compete with your Parkinson medications getting to the  
brain.  Try hot oat bran cereal in the morning instead, which reduces  
the amount of protein, adds the needed bulk, and helps stimulate the  
gastrocolic reflex.  Experiment with adding bran when cooking  
casseroles and eggs.  You can also substitute 1-2 tablespoons of bran  
for each cup of flour when baking.
Don't increase dietary fiber too quickly or you'll risk bloating and  
abdominal cramps. If discomfort occurs, cut back your fiber intake,  
increase your fluids, and apply a hot water bottle to the abdomen and  
check with your doctor.

Avoid constipating foods like cheese, rice and bananas.

Prunes contain compounds believed to stimulate bowel contractions.

Massage your belly regularly from the rib cage to the pubic bone.

    Drink six to eight 8-ounce glasses of water every day to help  
prevent “rock-like” stools. Hot liquids will often stimulate bowel  
activity. Avoid drinks that cause dehydration such as tea, coffee and  
alcohol.  Drink as early in the day as possible so that you don’t have  
to get up at night to urinate.   Cut back on milk drinks, as milk can  
cause constipation in some people.

    Increase your activity level by exercising regularly.  This will  
help stretch and strengthen the abdominal and pelvic muscles.   
Vigorous exercise isn’t necessary, but just doing a few stretches or  
sit-ups isn’t enough.  Walking helps propel the stool into the lower  
intestine.

    Good toilet habits. When your body gives you the signal you need  
to go, don’t postpone.  Set aside a scheduled time of day, when you  
have time to relax and move your bowels. Sit comfortably on the  
commode, feet flat on the ground or possibly drawing up your knees.  
Never sit longer than 5 minutes or strain to pass hard stool. You  
don’t want to risk getting hemorrhoids.

    Laxatives may diminish with continued use and some of the side  
effects can be serious. Be aware that any method of softening the  
stool does not give immediate results and is ineffective for chronic  
or severe constipation.

    Enemas or laxatives that stimulate can cause severe cramping and  
chronic use can deplete blood potassium levels and damage the bowel  
and should only be used as a last resort.

       If simple measures don't work or if you have bloody bowel  
movements, pain, unexplained weight loss or you are still constipated  
after three weeks despite your best efforts, see your doctor to rule  
out more serious causes of your discomfort.


  Nina
"Circumstances determine our lives, but we shape our lives by what we  
make of our circumstances."






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