I wrote an article for the Parkinson Foundation of Harris County
newsletter in July on Constipation.  It probably has a lot of info
gleaned from our list.  Perhaps it will have something of value in it
for you.

                KEEP ON MOVING

We know all too well that Parkinson’s is a movement disorder.  One of
the least discussed “movement” problems is constipation.  Although it
can be a concern for anyone, it can be a very troublesome symptom for
someone with Parkinson's.  The prevalence of this condition appears to
be related to the duration and severity of the disease. This common
complaint, due to the disease process itself, is caused by the
slowness of movement affecting the muscles that control the
bowels—slowing the passage of stool through the large intestine.
Because of this delayed transit, one study defined constipation with
regard to Parkinson’s as less frequent bowel movements, rather than
difficulty with defecation.

Furthermore, you get a “double whammy” because the side effects of
most anti-Parkinson drugs increase the tendency toward constipation.
So what can you do?  Remember…

             Constipation is easier to prevent than treat.
*   Add more roughage and high fiber foods to your diet to increase
the bulk of the stool.  Eat plenty of fresh fruit and vegetables.  At
least two meals a day should include high-fiber raw vegetables such as
carrots, cauliflower and broccoli or nuts and dried fruits (raisins,
prunes, or apricots).  Prunes contain compounds believed to stimulate
bowel contractions.  If you have a problem chewing or swallowing, to
get that necessary roughage, try grating your food or use a blender.
Enjoy high-fiber snack foods such as sesame bread sticks, date nut
bread, oatmeal cookies, fig newtons, granola, raisin bars and corn
chips.

* Add fiber by sprinkling bran into applesauce, on cereal or mixed
into yogurt.  If you have cold cereal, be aware if you add milk, the
protein competes with anti-parkinson medications in 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.  Try adding bran when cooking casseroles and
eggs.  You can also substitute 1-2 tablespoons of bran for each cup of
flour when baking.

* Avoid constipating foods like cheese, rice, bananas, etc.

* Drink at least eight 8 ounce glasses of water every day to help
prevent those “rock-like” stools.  Hot liquids will often stimulate
bowel activity.  Drink as early in the day as possible so that you
don't have to get up at night to urinate.

* 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, so we’ll cover the proper methods for walking in a two-part
exercise series beginning this month.

*  Don't postpone when your body gives you the signal you need to go.
Set aside a time of day to move your bowels when you have plenty of
time to relax.  Sit comfortably on the commode, possibly drawing up
your knees.  Don't strain too hard.  You don't want to risk getting
hemorrhoids.

Although you may feel bloated, it's not necessary for most people to
have a bowel movement every day; but because constipation can become
serious with PD, it should be well managed.  If you think you need a
laxative, call your physician first.  Some laxatives may diminish with
continued use and some of the side effects can be serious.  And, as
always, make your doctor aware of any other medications you take.

Over the counter, bulk-producing psyllium laxatives such as Metamucil
or Fiberall or methyl cellulose compounds, such as Citrucel, are the
mildest and can be helpful with small, hard, dehydrated stools.  Note
that some of these compounds contain a lot of sugar.  Glycerin
suppositories can help ease the passage of hard stools or you could
try a stool softener such as Colace or Ex-Lax; but 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 should be used as a last resort.  They can cause severe
cramping and chronic use can deplete blood potassium levels and damage
the bowel.

      Walking is one of the best prescriptions you can follow for
maintaining good health.  Step by step, day by day, walking can help
you experience a greater balance and awareness by opening the door to
communication between your body and your mind.  A good example of this
is tension--which can also be a cause of constipation.  Walking can
help relieve both the tension and constipation.

You might also consider reflexology as another alternative to
alleviating constipation.  Reflexology is an ancient art based on the
principle that we have areas in the feet that correspond to every part
of the body.

Laura Norman, author of Feet First: A Guide to Foot Reflexology
suggests that you sit in a comfortable position in a quiet room.  Pour
a bit of moisturizing lotion on your hands and massage your feet with
stroking, squeezing, kneading and wringing motions for five to 10
minutes.  Press both thumbs deeply into the arch area on the sole of
the foot and hold for a few moments.  This is the region of the foot
that corresponds to the digestive tract.  Applying pressure is
supposed to break up congestion and increase flow.

There are many more solutions that are available to give you relief if
you suffer from constipation.  Investigate them all.