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." ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn