It is easy to become obsessed with bowel activity, but it is not necessary to have a bowel movement every day – it can be quite normal for some people to empty their bowels only three or four times a week. What is important, is that passing stools is not painful nor causes unnecessary strain. Focus on what is normal and healthy for you and remember that bowel activity is affected by food and exercise, so will vary according to what you are eating and doing.
Remember that learning to manage your bowels will take time and patience, so don’t expect to solve problems overnight. It may take a few weeks to adjust diet etc, so don’t give up too quickly. There are also plenty of ways you can help yourself:
A healthy lifestyle can reduce the symptoms of constipation and increased fibre and fluid are key factors. However, too much bulk from fibre can increase constipation so the balance needs to be right – your doctor should be able to refer you to a dietician for help with this.
Any increase in fibre should be gradual to avoid flatulence (wind) or bloating. There are many ways in which you can increase fibre in your diet, including:
But if you feel unable to increase your fluid and fibre intake because of eating and drinking difficulties, you could try these practical suggestions:
However, you may find increasing your natural fibre and fluid intake does not relieve constipation, then medications such as bulk formersor stool softeners may help. There are several products on the market so ask your doctor or a dietician for advice.
Physical exercise is a key factor in relieving or preventing constipation. Exercise can stimulate the bowel muscles and improve your ability to pass stools. It can also strengthen the pelvic floor muscles, which helps reduce constipation.
If you find exercise difficult, a physiotherapist can advise further. Parkinson Italia also have very useful exercises on their website www.parkinson-italia.info/e_gym_uk/ and the Parkinson’s Disease Society has an exercise video (www.parkinsons.org.uk/?page=8045 to order) and accompanying information sheet.
It is important to try to relax when going to the toilet. Try not to rush and make sure that you do not become too preoccupied with your bowels. If your feet do not touch the floor when sitting on the toilet, then try putting a small stool or foot rest under them, so that they are resting on something and you are more comfortable. Don’t sit on the toilet for more than about five minutes and don’t strain hard to pass a stool. Listen to your body, leave it for a while and try again later.
It is important to be proactive in initiating a dialogue with healthcare professionals in order to best manage your symptoms. At one time, non-motor symptoms such as constipation received far less attention but there is now a growing awareness of this aspect of Parkinson’s. You can help manage your constipation by recognising that assistance is needed and talking to the healthcare professionals that can provide such help.
Unfortunately failure by healthcare professionals to recognise those most at risk of developing constipation used to be a major problem in managing the condition. This, coupled with the patient’s embarrassment in approaching the subject, meant that it often went undiagnosed or untreated for some time. Fortunately, most of those at risk are now identified early and preventative measures can be put in place to reduce the risk of severe complications. A proactive approach to treatment really can reduce the impact that constipation has for most people.
Liquidised food from the stomach can take over two days to travel through the bowel. The first two to six hours are in the small intestine where the food is fully digested and the nutrients absorbed. The remaining time (12 to 48 hours) is spent in the large intestine where most of the water content is absorbed.
A dietician advises on a healthy diet and specific dietary needs. They can offer advice on how diet can ease some symptoms, such as constipation. They may also liaise with a speech and language therapist regarding swallowing and eating difficulties.
A substance that increases the amount of urine passed.
The muscles located between the back, front and sides of the pelvic bones and “create pelvic floor”, stretching from the pubic bone at the front of the body to the tail bone in the back.
These muscles support the pelvic organs such as the bladder, bowel and uterus (in women) in place. They are involved in the control of urination and bowel elimination, as well as the sexual response.
They can be weakened by many disorders, including Parkinson’s and cause continence problems. Pelvic floor exercises can help overcome these difficulties.
Symptoms other than those affecting movement. In Parkinson's disease they include depression, drooling, swallowing problems, fatigue, pain, and sleep /night-time problems.
A condition where it becomes difficult to empty faeces from the bowel or where the stool is small, hard, and difficult or painful to pass.
See section Bowel Problems including Constipation.
Foods, compounds, or medication taken to induce bowel movements, most often taken to treat constipation.
Rhythmic shaking of part of the body. It is one of the main symptoms of Parkinson's disease, although it is not experienced by everyone.
This is where food passes from the stomach and is broken down into nutrients that the body can absorb and use. Most digestion occurs here as nutrients are absorbed from food.
The small intestine is section of the intestines between the stomach and the colon and includes the duodenum (closest to the stomach), the jejunum, and the ileum (closest to the large intestine).
