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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