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.