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Regarding my original post asking if others have noticed a worsening of symptoms if in a constipated state, it seems a little more information from me would be helpful. The doctors tell me Sinemet is not absorbed from the colon. It is absorbed from the small intestine, they say. So my contention is that either they are wrong or there is some problem even with the small intestine. Stephan Schwartz (understandably) questioned what I meant by greatly worsening conditions and what required a 4-week hospital stay. We had a terribly icy winter here on the East Coast in (I think) 1995. The ground was frozen, then it rained, and rained. So like a lot of others we got water in the house. My husband and I worked on getting that water taken care of. He was able to do this very well. But he'd been having some bowel problems and I finally decided I wanted a gastroenterologist. We had an appointment, but about three days after the water incident we met this doctor not in the office but as an in-patient. I mentioned the water cleanup, not because it caused the problem; but because the doctors and nurses couldn't believe that the patient they were seeing had been able-bodied just two or three days before. He was so stiff. He required nursing then the rehab where he learned how to walk again etc. He did well and returned to all his normal activities which included yard work, some wood chopping etc. But he'd been put on Golytely (cute name). This is a product that is normally used before an x-ray or surgery to cleanse the intestinal tract. And the normal amount to drink is a gallon. (It comes as a powder in a gallon jug and you add the water.) But we varied the amount as needed, usually two to four cups per day. Last May he was hospitalized with a blockage. A volvulus (or kink) in the colon was removed. Surgery was uneventful and he made a nice recovery. But now he is again experiencing the inability to move at times. I am trying to figure out if it's just the progression of the disease or if the output is not equallying the input and the plumbing is backing up again. This despite our Golytely routine (supplemented by enemas). There was one thing that happened in the days before the surgery which was very interesting. He'd been getting his usual medication every two hours. When they opened up the kinked area and kept it open (before the surgery), he became paranoid. It seemed like all that Sinemet had been somewhere, not working. Then it hit his system all at once. There was no other good explanation. Where was it? What was it doing or not doing? At least one of you told me that, yes, the Sinemet is not as effective if constipated. That's what I wanted to know. A colectomy/ileostomy has been mentioned. That's pretty drastic even if I can "change a mean colostomy bag" (my mother had one). So, friends, prevent a megacolon from developing in the first place if you can. See another, possibly helpful, post on "Getting Out of Bed."