Nice article, Nina! Thanks.

Kathleen

2009/8/27 Nina P. Brown <[log in to unmask]>

> 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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