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Dear Phil, A good reply would require a pharmacist and/or a neurologist; but I'll answer the bits that I can. > First, there is a description of the workings of the digestive > system in an e-text booklet from Colorado State University: > http//arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/index.html CSU is my alma mater and I recognized one of my former profs, so I enjoyed navigating this site! > Two states of the system are described that have widely > differing influences on oral medication. But bear in mind that the demonstration (if I'm referring to the same text you are, the site is pretty large) is with regard to a healthy animal. Although the basics are quite similar for humans, there are differences, and further differences for a human with PD. > Emptying the stomach is regulated by a feedback mechanism in the > instestines. When fats are detected signals are sent back to the > stomach to slow down its activity. This in turn slows down gastric > emptying. No timings are given. How long can gastric emptying > take? Gastric emptying can take up to 3-4 hours if a large amount of fat is eaten. > What is the effect on drug delivery of various proportions of > dietary fat? Drug delivery is greatly delayed if the med is taken with a large, high-fat meal. > Ingesting only a very small quantity may not stimulate gastric > activity. A degree of gastric distension from volume of contents is > needed for that. This seems to suggest that taking one's pills with > just a swollow of water won't be sufficient to get them to the small > intestine where they will be absorbed. Bear in mind again that the text referred to healthy animals. Drug companies design medications to be used by people in various disease states, and the various components of the medication (coating, etc.) are especially formulated to counteract these difficulties. A pharmacist could give a good explanation here. > Now some more questions. The usual recommendation I hear for taking > PD medications is 30 minutes before meals. Is the idea here to get > the pills into the small intestines before beginning the next meal? In the case of meds containing levodopa, yes. This is because any proteins eaten will be broken down into their components, amino acids; and the aminos will compete with levodopa for absorption in the small intestine. Taking the levodopa ahead of time gives it a clear field in the intestine. -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538 "If we knew what it was we were doing, it would not be called research, would it?" -Albert Einstein