Constipation, one of those unpleasant topics to talk about, often
significantly affects people with Parkinson's disease. If you've ever
suffered from constipation, you know it can be both painful and
frustrating. Although not often serious, constipation can be a
concern. You might find knowing the causes and cures to be helpful.

What is constipation?
Constipation occurs when bowel movements become difficult or less
frequent. The normal length of time between bowel movements (also
known as "stools") ranges widely from person to person. Some people
have bowel movements three times a day; others only one to two times
a week. Going longer than three days without a bowel movement is too
long. After three days, the stool becomes harder and more difficult
to pass.

What causes constipation in people with Parkinson's disease?
In some patients with Parkinson's disease, constipation might occur
due to the improper functioning of the autonomic nervous system. The
autonomic nervous system is responsible for regulating smooth muscle
activity. If this system is not working properly, the intestinal
tract might operate slowly, causing constipation.

In addition, some medicines used to treat Parkinson's disease can
cause constipation, particularly the anti-cholinergic agents such as
trihexyphenadyl (Artane) and benztropine (Cogentin).

What are other causes of constipation?
Common causes of constipation are:

Inadequate fiber in the diet
Not drinking enough water
Lack of exercise
Travel or other changes in routine
Eating large amounts of dairy products
Stress
Resisting the urge to have a bowel movement
Pain from hemorrhoids that causes a person to resist bowel movements
Overuse of laxatives (stool softeners) which, over time, weaken the
bowel muscles, and antacid medicines containing calcium or aluminum
Other medicines (especially antidepressants, iron pills, and strong
pain medicines such as narcotics)
Irritable bowel syndrome (IBS)
Pregnancy
Rarely, various medical conditions can cause or aggravate
constipation. Some of the more common medical conditions that cause
constipation include endocrine problems, such as poor function of the
thyroid gland or diabetes. Colorectal cancer is another medical
condition that can cause constipation.

How can constipation be prevented?

Eat a well-balanced diet with plenty of fiber. Good sources of fiber
are fruits, vegetables, legumes, and whole grain bread and cereal.
Fiber and water help the colon pass stool. Most of the fiber in
fruits is found in the skins. Fruits with edible seeds, such as
strawberries, have the most fiber. Eat bran cereal or add bran cereal
to other foods, such as soup and yogurt. Bran is a great source of
fiber.
Drink 1½ to 2 quarts of water and other fluids a day. (Note: Milk can
cause constipation in some people.) Liquids that contain caffeine,
such as coffee and soft drinks, seem to have a dehydrating effect and
might need to be avoided until your bowel habits return to normal.
Exercise regularly.
Move your bowels when you feel the urge.
How is constipation treated?

Drink two to four extra glasses of water a day.
Try warm liquids, especially in the morning.
Add fruits and vegetables to your diet.
Eat prunes and/or bran cereal.
If needed, use a very mild stool softener or laxative (such as
Pericolace or Milk of Magnesia). Do not use laxatives for more than
two weeks without calling your health care provider, as laxative
overuse can aggravate your symptoms.
Call your health care provider if:

Constipation is a new problem for you
You have blood in your stool
You are losing weight even though you are not trying to lose
You have severe pain with bowel movements
Your constipation has lasted more than three weeks