Kathrynne- A thank you and a question.  I have been using your helpful on-line
words to others for the last few months and have ordered your book.  Everything
you say makes sense and I appreciate your help.
My question comes out of my growing problem with fecal incontinence.  My internist
and neurologist have told me that what I had thought was diarrhea is really
constipation overflow and now the Gastroenterologist the Neuro sent me to says
that the anal sphincter is completely gone and although I should increase my fiber
intake (which is about 20-25 grams now) and increase my Fibercon and water intake,
the only real help I can expect is from an enema every other morning.  He said
this might be forever or perhaps I would find some help after a while with
suppositories and the Fibercon and Fiber.  At first I was horrified (as I have
never had an enema except for pre-surgery) but after the first week of this I find
I feel quite liberated, able to go out without fear for the first time in a long
while.  Giving myself the enemas is a nuisance, but that's all.
I exercise with a trainer 3 mornings a week and have felt unable to even go
walking--and now I can.  And I have been terrorized by my digestive system
whenever I travel for work or pleasure--and now feel I can go to Italy in August
with some control over my bowels.

Do you think I am making a mistake by going this route?  Perhaps this isn't a fair
question but if you have an opinion on this, I would very much appreciate hearing
from you.

Thanks

Kathrynne Holden, MS,RD wrote:

> Dear Ralph,
>
> > I would be grateful for nutritional information on how to AVOID becoming
> > constipated.
>
> For many, if not most PWP, there is peristalsis, or slowing, of the
> gastrointestinal tract.-the throat muscles may not move food as quickly to the
> stomach
> -the stomach often takes longer to process the food and empty it into the
> small intestine (gastroparesis)
> -the small intestine may take longer to move the bolus of food throughout its
> length and empty it into the colon
> -the muscles of the colon move much more slowly, so the bolus remains in the
> colon longer, turning dry and hard and becoming difficult to pass
>
> Fiber and fluid are more necessary for PWP than for most others. Fiber soaks
> up fluid and holds it as it passes thru the GI tract. In the colon, it helps
> the fecal matter to remain soft, even though the colon isn't moving as quickly
> as it should. Fiber also acts to lower risk of colorectal cancer -- this risk
> is increased with chronic constipation.
>
> I recommend drinking plenty of water -- at least two quarts a day --
> especially as the PD meds such as Eldepryl and Sinemet may lead to fluid loss
> due to polyuria (urinating more than usual), and/or excess sweating. Besides
> needing fluid to help alleviate constipation, PWP frequently are treated for
> urinary tract infections due to chronic dehydration.  I also recommend eating
> whole grains (whole wheat, oats, brown rice, whole rye, etc.) and cooked dried
> beans (kidney beans, baked beans, etc.) as often as possible. Fruits and
> vegetables are also rich in fiber, and protective against cancer.
>
> > Also, does "5 helpings of fruits & vegetables daily" mean 5 of BOTH fruits
> > & vegs, or 5 of EACH - as suggested in the nutritional "pyramid" often
> > seen on food packages?
>
>  Five a day means at least 3 servings of vegetables and 2 of fruit. That's for
> a small or inactive woman. Larger or more active women, and men, need extra
> servings, depending on size and activity level.
>
> My very best regards,
> Kathrynne
>
> --
> Kathrynne Holden, MS, RD
> "Nutrition you can live with!"
> Medical nutrition therapy
> http://www.nutritionucanlivewith.com/
> Tel: 970-493-6532 // Fax: 970-493-6538